What is the Medical Student Experience of Incivilities on the Surgery Clerkship and Do They Matter?

OBJECTIVE

To study medical students' experiences with incivilities on the surgery clerkship DESIGN: A retrospective cross-sectional survey study based on the Workplace Incivility Scale 12 (WIS-12) that quantified the frequency of experienced incivilities, averaged the frequency of all twelve incivilities as an index, and characterized how they affected students' perceptions of surgery SETTING: A single large urban medical school affiliated with multiple quaternary level medical centers PARTICIPANTS: From October 2022 to 2023, all medical students on their surgery clerkship at 3 different medical centers received a paper survey near the end of the 12-week clerkship period. The response rate was 83% (118/144), of whom 41% self-identified as male and 38% as White.

RESULTS

Ninety-seven percent of respondents experienced an incivility during the clerkship, the most frequent of which was receiving little attention for their opinions (3.07 ± 1.34, mean ± standard deviation), being interrupted (2.36 ± 1.38), and being ignored (2.27 ± 1.37). Students whose interest in a surgical career decreased by the end of the clerkship had a significantly higher index of incivility than those whose interest increased or remained stable (2.13 ± 0.86 vs. 1.70 ± 0.58 respectively, p < 0.005). Students whose perception of surgical culture worsened by the end of the clerkship had a significantly higher index compared to those whose perceptions improved or remained stable (2.12 ± 0.71 vs. 1.68 ± 0.59 respectively, p < 0.05).

CONCLUSIONS

Medical students reported incivilities as nearly ubiquitous during the surgery clerkship. A higher frequency of these experiences was associated with decreased interest in surgery and worse perceptions of surgical culture. Surgical educators should track and intervene on these behaviors during the clerkship. Other specialties should study these phenomena as well.