- •Forty-eight percent of residents and 29% of faculty experienced mistreatment.
- •The most common form of mistreatment for both groups was public humiliation.
- •The most common instigator for both groups was faculty.
- •Residents and faculty do not report mistreatment.
Mistreatment has been correlated with burnout and poor well-being in medical students, but data regarding residents and faculty are limited. The objective was to investigate the prevalence of mistreatment towards surgical housestaff and faculty and characterize such experiences.
In 2018, the Department of Surgery surveyed housestaff and faculty on incidents of mistreatment.
Clinical faculty (63%) and residents (72%) completed the mistreatment survey. Excluding public embarrassment, 48% of residents and 29% of clinical faculty experienced mistreatment. Residents experienced public embarrassment and public humiliation more frequently than faculty, however faculty were subjected to racially or ethnically offensive remarks/names more frequently than residents (p < .05). Faculty within and external to their department were most cited as instigators of mistreatment. Residents experienced mistreatment most often by faculty, co-residents, and nurses. Reporting of the behaviors was low.
Incidents of mistreatment are frequently occurring for surgical residents and faculty.
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- Physician wellness: a missing quality indicator.Lancet. 2009; 374: 1714-1721https://doi.org/10.1016/S0140-6736(09)61424-0
- Medical student perceptions of a mistreatment program during the surgery clerkship.Am J Surg. 2018; 215: 761-766https://doi.org/10.1016/j.amjsurg.2018.01.001
- In defense of “pimping.J Surg Educ. 2015; 1: 176-177https://doi.org/10.1016/j.jsurg.2014.06.012
- Mistreatment and the learning environment: a mixed methods approach to assess knowledge and raise awareness amongst residents.J Surg Educ. 2019; 76: 305-314https://doi.org/10.1016/j.jsurg.2018.07.019
- Caught in the middle: a resident perspective on influences from the learning environment that perpetuate mistreatment.Acad Med J Assoc Am Med Coll. 2016; 91: 301-304https://doi.org/10.1097/ACM.0000000000001058
- ‘You learn better under the gun’: intimidation and harassment in surgical education.Med Educ. 2005; 39: 926-934https://doi.org/10.1111/j.1365-2929.2005.02247.x
- Medical school graduation Questionnaire all schools summary report.Accessed December 5, 2018)
- An empirical national assessment of the learning environment and factors associated with program culture.Ann Surg. 2019; 270: 585https://doi.org/10.1097/SLA.0000000000003545
- Discrimination, abuse, harassment, and burnout in surgical residency training.N Engl J Med. 2019; 381: 1741-1752https://doi.org/10.1056/NEJMsa1903759
- Program requirements for graduate medical education in emergency medicine.http://www.acgme.org/acgmeweb/Portals/0/PFAssets/2013-PR-FAQ-PIF/110_emergency_medicine_07012013.pdf(Accessed December 5, 2018)Date: 2012
- Leadership development programs for physicians: a systematic review.J Gen Intern Med. 2015; 30: 656-674https://doi.org/10.1007/s11606-014-3141-1
- A framework for professionalism in surgery: what is important to medical students?.Am J Surg. 2014; 207: 255-259https://doi.org/10.1016/j.amjsurg.2013.08.027
- Eradicating medical student mistreatment: a longitudinal study of one institution’s efforts.Acad Med J Assoc Am Med Coll. 2012; 87: 1191-1198https://doi.org/10.1097/ACM.0b013e3182625408
- A real-time mobile web-based module promotes bidirectional feedback and improves evaluations of the surgery clerkship.Am J Surg. 2015; 209: 101-106https://doi.org/10.1016/j.amjsurg.2014.08.035
- Intimidation and harassment in residency: a review of the literature and results of the 2012 Canadian association of interns and residents national survey.Can Med Educ J. 2014; 5: e50-57
- Residents’ experiences of abuse, discrimination and sexual harassment during residency training. McMaster University Residency Training Programs.CMAJ J Assoc Medicale Can. 1996; 154: 1657-1665
- Learning, satisfaction, and mistreatment during medical internship: a national survey of working conditions.J Am Med Assoc. 1998; 279: 1194-1199
- A systematic review of the prevalence of patient assaults against residents.J Grad Med Educ. 2012; 4: 296-300https://doi.org/10.4300/JGME-D-11-00184.1
- Harassment and discrimination in medical training: a systematic review and meta-analysis.Acad Med J Assoc Am Med Coll. 2014; 89: 817-827https://doi.org/10.1097/ACM.0000000000000200
- Discrimination and abuse experienced by general internists in Canada.J Gen Intern Med. 1995; 10: 565-572
- Psychological violence against general practitioners and nurses in Chinese township hospitals: incidence and implications.Health Qual Life Outcome. 2018; 16: 117https://doi.org/10.1186/s12955-018-0940-9
- Organizational factors contributing to incivility at an academic medical center and systems-based solutions: a qualitative study.Acad Med J Assoc Am Med Coll. 2018; 93: 1569-1575https://doi.org/10.1097/ACM.0000000000002310
- Perceived bullying among Norwegian doctors in 1993, 2004 and 2014-2015: a study based on cross-sectional and repeated surveys.BMJ Open. 2018; 8e018161https://doi.org/10.1136/bmjopen-2017-018161
- Disruptive behaviour in the perioperative setting: a contemporary review.Can J Anaesth. 2017; 64: 128-140https://doi.org/10.1007/s12630-016-0784-x
- Perspective: a culture of respect, part 1: the nature and causes of disrespectful behavior by physicians.Acad Med J Assoc Am Med Coll. 2012; 87: 845-852https://doi.org/10.1097/ACM.0b013e318258338d
- Measuring mistreatment: honing questions about abuse on the association of American medical Colleges graduation Questionnaire.Virt Mentor. 2014; 16: 196-199
- Why and when hierarchy impacts team effectiveness: a meta-analytic integration.J Appl Psychol. 2018; 103 (0125): 591https://doi.org/10.1037/apl0000291
- The effects of power, leadership and psychological safety on resident event reporting.Med Educ. 2016; 50: 343-350https://doi.org/10.1111/medu.12947
- An exploratory study of employee silence: issues that employees don’t communicate upward and why*.J Manag Stud. 2003; 40: 1453-1476
- Discussing the undiscussable with the powerful: why and how faculty must learn to counteract organizational silence.Acad Med. 2014; 89: 1610-1613https://doi.org/10.1097/ACM.0000000000000428
- Reinventing Diversity: Transforming Organizational Community to Strengthen People, Purpose, and Performance.Rowman & Littlefield Publishers, 2011
- Unseen injustice: incivility as modern discrimination in organizations.Acad Manag Rev. 2008; 33: 55-75https://doi.org/10.5465/amr.2008.27745097
- Sexual Harassment of Women: Climate, Culture, and Consequences in.Academic Sciences, Engineering, and Medicine2018https://doi.org/10.17226/24994
- The leader’s guide to corporate culture.Harv Bus Rev. February 2018; : 10
- Workplace harassment from the victim’s perspective: a theoretical model and meta-analysis.J Appl Psychol. 2006; 91: 998-1012https://doi.org/10.1037/0021-9010.91.5.998
- When the learning environment is suboptimal: exploring medical students’ perceptions of “mistreatment.Acad Med. 2014; 89: 608-617https://doi.org/10.1097/ACM.0000000000000172
- Making business personal.Harv Bus Rev. 2014; (April 2014) (Accessed May 7, 2019)
Published online: February 03, 2020
Accepted: November 23, 2019
Received in revised form: November 17, 2019
Received: May 10, 2019
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