Barrett Jenny, Scott Karen M
Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia.
Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
J Paediatr Child Health. 2018 Jan;54(1):69-73. doi: 10.1111/jpc.13656. Epub 2017 Aug 2.
The continuing existence of 'teaching by humiliation' of medical students and junior doctors in Australia has recently been highlighted in a number of research publications and media reports. This study investigates medical students' experiences of being intimidated or humiliated during their clinical rotations in Australian hospitals in paediatrics and adult medicine.
From factors identified in earlier research, a two-page survey was developed for administration at two Australian medical schools. Administered in Semester 2 of 2014, students were invited to add their own free-text comments at the conclusion of 17 closed questions. Using thematic analysis of the qualitative data, the researchers identified the common themes in the students' free-text comments, which are reported in this paper.
We found five main themes in the qualitative data: a spectrum of interpretations of and responses to 'teaching by humiliation', an accepted means of enculturating the young, teachers' techniques for asking questions, the victims and perpetrators of mistreatment and the variance of prevalence in different contexts.
Research shows the persistence of 'teaching by humiliation', even in paediatrics, particularly when doctors are questioning students in ways that shame them for their lack of knowledge. Given the many personal and professional costs of these practices, this cycle of mistreatment needs to be brought to an end. There is a need for students' reports of intimidation and humiliation to be acknowledged; the offending practices need to be interrupted, and more effective and respectful approaches to teaching need to be adopted.
澳大利亚医学生和初级医生“羞辱式教学”的持续存在最近在一些研究出版物和媒体报道中得到了突出强调。本研究调查了医学生在澳大利亚医院儿科和成人医学临床轮转期间受到恐吓或羞辱的经历。
根据早期研究中确定的因素,编制了一份两页的调查问卷,用于在两所澳大利亚医学院校进行施测。该问卷于2014年第二学期进行施测,在17个封闭式问题结束时,邀请学生添加自己的自由文本评论。通过对定性数据进行主题分析,研究人员确定了学生自由文本评论中的共同主题,本文对此进行了报道。
我们在定性数据中发现了五个主要主题:对“羞辱式教学”的一系列解读和反应、一种被认可的培养年轻人的方式、教师提问技巧、虐待行为的受害者和实施者以及不同背景下患病率的差异。
研究表明,“羞辱式教学”依然存在,即使在儿科也是如此,尤其是当医生以学生缺乏知识为由使其蒙羞的方式提问时。鉴于这些行为会带来诸多个人和职业成本,这种虐待循环需要终止。有必要承认学生关于恐吓和羞辱的报告;需要中断冒犯性的行为,并采用更有效、更尊重他人的教学方法。