Mistreatment and the learning environment for medical students on general surgery clerkship rotations: What do key stakeholders think?

Abstract Background Mistreatment has potential downstream effects on students. General surgery rotations tend to have a higher incidence of mistreatment reports. This study was undertaken to identify dominant themes contributing to a negative learning environment. Methods A qualitative study was per...

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Bibliographic Details
Published in:The American journal of surgery 2017-02, Vol.213 (2), p.307-312
Main Authors: Castillo-Angeles, Manuel, Watkins, Ammara A, Acosta, Danilo, Frydman, Julia L, Flier, Lydia, Garces-Descovich, Alejandro, Cahalane, Michael J, Gangadharan, Sidharta P, Atkins, Katharyn M, Kent, Tara S
Format: Article
Language:English
Subjects:
Attitude of Health Personnel
Clerkship
Clinical Clerkship
Delphi Technique
Education, Medical, Undergraduate
Faculty, Medical
Feedback
Focus Groups
General Surgery - education
Humans
Internship and Residency
Interpersonal Relations
Learning
Massachusetts
Medical student
Mistreatment
Neglect
Nurses
Organizational Culture
Physicians
Qualitative Research
School environment
Social Behavior
Students
Students, Medical - psychology
Studies
Surgeons
Surgery
Teaching
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Summary:Abstract Background Mistreatment has potential downstream effects on students. General surgery rotations tend to have a higher incidence of mistreatment reports. This study was undertaken to identify dominant themes contributing to a negative learning environment. Methods A qualitative study was performed using Delphi consensus technique to develop a discussion guide. Four focus groups were performed (n = 30 participants) with medical students, residents, nurses, and attending surgeons. Participants were selected using purposive-stratified criterion-based sampling. Results Multiple themes emerged: 1) unclear expectations for medical students; 2) passive mistreatment (neglect); 3) failure to integrate students into surgical team; 4) witnessed or experienced active mistreatment, 5) negative attitude of residents towards medical students' lack of knowledge. Conclusions Medical student mistreatment persists and is a threat to the learning environment and individual learning process. Passive mistreatment (neglect) represents the most distressing component of mistreatment. These findings suggest a need for education aimed at surgical residents and others in the learning environment.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2016.10.013