Richardson D A, Becker M, Frank R R, Sokol R J
Department of Gynecology-Obstetrics, Henry Ford Hospital, Detroit, Michigan, USA.
Acad Med. 1997 Aug;72(8):728-30. doi: 10.1097/00001888-199708000-00022.
To study medical students' perceptions of mistreatment in their second and third years of training.
A questionnaire was distributed at Wayne State University School of Medicine to the class of 1993 at the end of its third year and to the class of 1994 at the end of its second and third years. The students were asked if they had been subjected to various forms of mistreatment; the third-year students were asked to rate their perceptions of each clinical department's response to them on the basis of gender and race-ethnicity, as well as their overall treatment. The students also completed demographic information about age, gender, and marital status, number of children, and race-ethnicity. Results were analyzed using chi-square statistics, multivariate statistical analyses, analyses of variance, and Duncan's post-hoc comparisons.
The response rate for the class of 1993 was 71.5%; response for the class of 1994 were 66.9% in their second year and 75.2% in their third year; 41.7% were women, and the racial-ethnic breakdown was 71.2% white/Caucasian, 11.7% black/African American and 16.8% other. There was a significant difference between the percentages of second-year and third-year students reporting any experience of mistreatment (37.2% vs 75.8%, p < .001). Canonical correlation analysis revealed bias in the third year based on gender (p < .0001) and race-ethnicity (p < .0002); both variates were related to sexual humor. The students' perceptions of mistreatment were lowest for family medicine and highest for obstetrics-gynecology and surgery. Perceptions of mistreatment in departments varied significantly by gender and race-ethnicity. The nonwhite males reported the least favorable treatment in most departments.
Marked variability in the students' perceptions of mistreatment within departments suggest that a variety of approaches will be required to improve the medical training environment.
研究医学生在培训第二年和第三年对虐待行为的认知。
在韦恩州立大学医学院，于1993级学生三年级末以及1994级学生二年级末和三年级末发放问卷。询问学生是否遭受过各种形式的虐待；三年级学生被要求根据性别、种族和民族以及他们的总体待遇，对每个临床科室对他们的反应进行评分。学生们还填写了有关年龄、性别、婚姻状况、子女数量和种族的人口统计学信息。使用卡方统计、多元统计分析、方差分析和邓肯事后比较对结果进行分析。
1993级的回复率为71.5%；1994级二年级的回复率为66.9%，三年级为75.2%；41.7%为女性，种族分布为71.2%白人/高加索人，11.7%黑人/非裔美国人，16.8%为其他种族。报告有任何虐待经历的二年级和三年级学生的百分比之间存在显著差异（37.2%对75.8%，p <.001）。典型相关分析显示三年级存在基于性别（p <.0001）和种族（p <.0002）的偏见；两个变量都与性幽默有关。学生对虐待行为的认知在家庭医学中最低，在妇产科和外科中最高。各科室对虐待行为的认知因性别和种族而异。在大多数科室中，非白人男性报告的待遇最不理想。
学生对各科室虐待行为的认知存在显著差异，这表明需要采取多种方法来改善医学培训环境。
