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Perceptions of mistreatment among trainees vary at different stages of clinical training

BACKGROUND: Mistreatment of trainees remains a frequently reported phenomenon in medical education. One barrier to creating an educational culture of respect and professionalism may be a lack of alignment in the perceptions of mistreatment among different learners. Through the use of clinical vignet...

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Autores principales: Kulaylat, Afif N., Qin, Danni, Sun, Susie X., Hollenbeak, Christopher S., Schubart, Jane R., Aboud, Antone J., Flemming, Donald J., Dillon, Peter W., Bollard, Edward R., Han, David C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5237524/
https://www.ncbi.nlm.nih.gov/pubmed/28088241
http://dx.doi.org/10.1186/s12909-016-0853-4
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author Kulaylat, Afif N.
Qin, Danni
Sun, Susie X.
Hollenbeak, Christopher S.
Schubart, Jane R.
Aboud, Antone J.
Flemming, Donald J.
Dillon, Peter W.
Bollard, Edward R.
Han, David C.
author_facet Kulaylat, Afif N.
Qin, Danni
Sun, Susie X.
Hollenbeak, Christopher S.
Schubart, Jane R.
Aboud, Antone J.
Flemming, Donald J.
Dillon, Peter W.
Bollard, Edward R.
Han, David C.
author_sort Kulaylat, Afif N.
collection PubMed
description BACKGROUND: Mistreatment of trainees remains a frequently reported phenomenon in medical education. One barrier to creating an educational culture of respect and professionalism may be a lack of alignment in the perceptions of mistreatment among different learners. Through the use of clinical vignettes, our aim was to assess the perceptions of trainees toward themes of potential mistreatment at different stages of training. METHODS: Based on observations from external experts embedded in the clinical learning environment, six thematic areas of potential mistreatment were identified: verbal abuse, specialty-choice discrimination, non-educational tasks, withholding/denying learning opportunities, neglect and gender/racial insensitivity. Corresponding clinical vignettes were created and distributed to 1) medical students, 2) incoming interns, 3) residents/fellows. Perceptions of the appropriateness of the interactions depicted in the vignettes were measured on a 5-point Likert scale. Scores were categorized into neutral or appropriate (≤3) or inappropriate (i.e. mistreatment) (>3) and compared using chi-squared tests. RESULTS: Four hundred twenty seven trainees participated (182 students, 120 interns, 125 residents/fellows). Proportions of students perceiving mistreatment differed significantly from those of interns and residents/fellows in domains of verbal abuse, specialty discrimination and gender/racial insensitivity (p < 0.05). In scenarios comparing interns to residents/fellows, no significant differences were noted in perceptions of mistreatment in the domains of non-educational tasks, withholding learning and neglect. CONCLUSIONS: Perceptions of mistreatment differ at different developmental stages of medical training. After exposure to the clinical learning environment, perceptions of incoming interns did not differ from those of residents/fellows, implicating clinical rotations as a key period in indoctrinating students into the prevailing culture. More longitudinal studies are needed to confirm or better examine this phenomenon. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12909-016-0853-4) contains supplementary material, which is available to authorized users.
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spelling pubmed-52375242017-01-18 Perceptions of mistreatment among trainees vary at different stages of clinical training Kulaylat, Afif N. Qin, Danni Sun, Susie X. Hollenbeak, Christopher S. Schubart, Jane R. Aboud, Antone J. Flemming, Donald J. Dillon, Peter W. Bollard, Edward R. Han, David C. BMC Med Educ Research Article BACKGROUND: Mistreatment of trainees remains a frequently reported phenomenon in medical education. One barrier to creating an educational culture of respect and professionalism may be a lack of alignment in the perceptions of mistreatment among different learners. Through the use of clinical vignettes, our aim was to assess the perceptions of trainees toward themes of potential mistreatment at different stages of training. METHODS: Based on observations from external experts embedded in the clinical learning environment, six thematic areas of potential mistreatment were identified: verbal abuse, specialty-choice discrimination, non-educational tasks, withholding/denying learning opportunities, neglect and gender/racial insensitivity. Corresponding clinical vignettes were created and distributed to 1) medical students, 2) incoming interns, 3) residents/fellows. Perceptions of the appropriateness of the interactions depicted in the vignettes were measured on a 5-point Likert scale. Scores were categorized into neutral or appropriate (≤3) or inappropriate (i.e. mistreatment) (>3) and compared using chi-squared tests. RESULTS: Four hundred twenty seven trainees participated (182 students, 120 interns, 125 residents/fellows). Proportions of students perceiving mistreatment differed significantly from those of interns and residents/fellows in domains of verbal abuse, specialty discrimination and gender/racial insensitivity (p < 0.05). In scenarios comparing interns to residents/fellows, no significant differences were noted in perceptions of mistreatment in the domains of non-educational tasks, withholding learning and neglect. CONCLUSIONS: Perceptions of mistreatment differ at different developmental stages of medical training. After exposure to the clinical learning environment, perceptions of incoming interns did not differ from those of residents/fellows, implicating clinical rotations as a key period in indoctrinating students into the prevailing culture. More longitudinal studies are needed to confirm or better examine this phenomenon. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12909-016-0853-4) contains supplementary material, which is available to authorized users. BioMed Central 2017-01-14 /pmc/articles/PMC5237524/ /pubmed/28088241 http://dx.doi.org/10.1186/s12909-016-0853-4 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Kulaylat, Afif N.
Qin, Danni
Sun, Susie X.
Hollenbeak, Christopher S.
Schubart, Jane R.
Aboud, Antone J.
Flemming, Donald J.
Dillon, Peter W.
Bollard, Edward R.
Han, David C.
Perceptions of mistreatment among trainees vary at different stages of clinical training
title Perceptions of mistreatment among trainees vary at different stages of clinical training
title_full Perceptions of mistreatment among trainees vary at different stages of clinical training
title_fullStr Perceptions of mistreatment among trainees vary at different stages of clinical training
title_full_unstemmed Perceptions of mistreatment among trainees vary at different stages of clinical training
title_short Perceptions of mistreatment among trainees vary at different stages of clinical training
title_sort perceptions of mistreatment among trainees vary at different stages of clinical training
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5237524/
https://www.ncbi.nlm.nih.gov/pubmed/28088241
http://dx.doi.org/10.1186/s12909-016-0853-4
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