D. Acosta is chief diversity and inclusion officer, Association of American Medical Colleges, Washington, DC. D.R. Karp is professor of sociology and director, Project on Restorative Justice, Skidmore College, Saratoga Springs, New York.
Acad Med. 2018 Mar;93(3):354-356. doi: 10.1097/ACM.0000000000002037.
The mistreatment of learners is an ongoing issue at U.S. medical schools. According to responses to the 2017 Association of American Medical Colleges Graduation Questionnaire, 39.3% of medical students nationally reported being mistreated. Many articles have been published on the topic of mistreatment at medical schools over the last 20 years. These articles have focused primarily on the definition of mistreatment, the impact of mistreatment, and initiatives put into place to help mitigate the problem. To date, very little attention has been paid to repairing the harm caused by mistreatment and rebuilding community trust. Academic medicine is in need of new forums of interaction to achieve more positive learning and workplace environments.The authors discuss restorative justice practices and the potential applications that they may have in academic medicine learning and workplace environments to serve vulnerable students, faculty, and staff who are targets of mistreatment. Restorative justice practices are used to convene groups of people to engage in substantive dialogue about consequential issues that impede community functioning. This process can help a group identify and gain mutual understanding of the personal and collective harm that has occurred, create the conditions that incentivize offenders to admit responsibility rather than deny or minimize the harm, and explore and define a set of problem-solving steps to address the harm and rebuild community trust.
美国医学院校的学生虐待问题一直存在。根据美国医学院协会 2017 年毕业生问卷调查的回复，全国有 39.3%的医学生报告曾遭受过虐待。在过去的 20 年里，已经有很多关于医学院虐待问题的文章发表。这些文章主要集中在虐待的定义、虐待的影响，以及为帮助减轻问题而采取的措施上。迄今为止，很少有人关注修复虐待行为造成的伤害和重建社区信任。学术医学需要新的互动论坛，以实现更积极的学习和工作环境。作者讨论了恢复性司法实践及其在学术医学学习和工作环境中的潜在应用，以帮助那些易受伤害的学生、教师和员工，他们是虐待的目标。恢复性司法实践用于召集一群人就妨碍社区运作的重大问题进行实质性对话。这一过程可以帮助一个群体识别和共同理解已经发生的个人和集体伤害，创造激励违法者承认责任而不是否认或最小化伤害的条件，并探讨和定义一套解决伤害和重建社区信任的问题解决步骤。
