Ellis Samantha, Purkiss Joel, Abdoler Emily, Opaskar Amanda, Mangrulkar Rajesh S, Kolars Joseph C, Santen Sally A
Department of Dermatology, University of California, Davis Medical Center, California, USA.
Baylor College of Medicine, Houston, Texas, USA.
Clin Teach. 2019 Apr;16(2):142-146. doi: 10.1111/tct.12790. Epub 2018 May 22.
As medical schools strive to improve the learning environment, it is important to understand medical students' perceptions of mistreatment. The purpose of this study was to explore student interpretations of previously reported mistreatment incidents to better understand how they conceptualise the interactions.
Medical students were presented with case scenarios of previously reported instances of mistreatment and asked to indicate their agreement as to whether the scenarios demonstrated mistreatment, using a five-point Likert scale (1, strongly disagree; 5, strongly agree). It is important to understand medical student's perceptions of mistreatment RESULTS: One hundred and twenty-seven third-year medical students gave feedback on 21 mistreatment cases. There was variability in the categorisation of the scenarios as mistreatment. The highest degree of consensus (96% agreement) was for a scenario in which a resident claimed a student made statements about a patient's status that the student did not make. There was also relative consensus on three additional scenarios: (1) a patient making disparaging remarks about a student's role in health care in relation to the student's ethnicity (88% agreement); (2) a resident asking a student to run personal errands (86% agreement); and (3) a nurse calling a student an expletive in front of others (77% agreement). For the majority of the cases, there was no consensus amongst students as to whether mistreatment had occurred. Students self-identifying as minorities and students who had previously reported mistreatment were more likely to perceive mistreatment in the scenarios.
There is remarkable variability, and in many cases a lack of agreement, in medical student perceptions of mistreatment. This inconsistency needs to be considered in order to effectively address and mitigate the issue.
随着医学院校努力改善学习环境，了解医学生对虐待行为的看法很重要。本研究的目的是探索学生对先前报告的虐待事件的解读，以更好地理解他们如何将这些互动概念化。
向医学生展示先前报告的虐待事件案例，并要求他们使用五点李克特量表（1，强烈不同意；5，强烈同意）指出他们是否同意这些案例表明存在虐待行为。了解医学生对虐待行为的看法很重要。结果：127名三年级医学生对21起虐待案例提供了反馈。将这些案例归类为虐待行为存在差异。对于一个案例，即一名住院医生声称一名学生做出了该学生并未做出的关于患者病情的陈述，达成了最高程度的共识（96%同意）。另外还有三个案例也达成了相对共识：（1）一名患者针对学生的种族发表关于该学生在医疗保健中角色的贬低性言论（88%同意）；（2）一名住院医生要求一名学生去办私人差事（86%同意）；以及（3）一名护士在他人面前对一名学生使用咒骂语（77%同意）。对于大多数案例，学生们对于是否发生了虐待行为并未达成共识。自我认定为少数群体的学生以及先前报告过遭受虐待的学生更有可能在这些案例中察觉到虐待行为。
医学生对虐待行为的看法存在显著差异，而且在许多情况下缺乏一致性。为了有效解决和缓解这个问题，需要考虑这种不一致性。
