Frequency and perceived severity of negative experiences during medical education in Germany--results of an online-survery of medical students

Perceptions of lecturers and students regarding discriminatory experiences and sexual harassment in academic medicine - results from a faculty-wide quantitative study

BACKGROUND

Discrimination and sexual harassment are prevalent in higher education institutions and can affect students, faculty members and employees. Herein the aim was to assess the extent of discriminatory experiences and sexual harassment of students and lecturers at one of the largest teaching hospitals in Europe. We analyze whether there are differences between lecturers and students, different study programs as well as sex/gender differences.

METHODS

In an interdisciplinary, iterative process, a semi-standardized questionnaire was developed and sent to N = 7095 students (S) of all study programs and N = 2528 lecturers (L) at Charité-Universitätsmedizin Berlin, Germany. The study was conducted from November 2018 to February 2019. Besides a broad range of questions on sociodemographic background allowing for diversity sensitive data analysis, they were asked if they had witnessed and/or experienced any form of discrimination or sexual harassment at the medical faculty, if yes, how often, the perceived reasons, situational factors and perpetrators.

RESULTS

The response rate was 14% (n = 964) for students and 11% (n = 275) for lecturers. A proportion of 49.6% of students (L: 31%) reported that they have witnessed and/or experienced discriminatory behavior. Sexual harassment was witnessed and/or experienced by 23.6% of students (L: 19.2%). Lecturers (85.9%) were identified as the main source of discriminatory behavior by students. Directors/supervisors (47.4%) were stated as the main source of discriminatory behavior by lecturers. As the most frequent perceived reason for discriminatory experiences sex/gender (S: 71%; L: 60.3%) was reported. Women and dental students experienced more discriminatory behavior and sexual harassment.

CONCLUSIONS

Discriminatory behavior is experienced by a significant number of students and lecturers, with power structures having a relevant impact. Dental students and women appear to be particularly exposed. Specific institutional measures, such as training programs for lecturers and students are necessary to raise awareness and provide resources. Furthermore, national preventive strategies should be thoroughly implemented to fight discrimination and harassment at the workplace.

Extent and types of gender-based discrimination against female medical students and physicians at five university hospitals in Germany - results of an online survey

Objective

There is a gap in research on gender-based discrimination (GBD) in medical education and practice in Germany. This study therefore examines the extent and forms of GBD among female medical students and physicians in Germany. Causes, consequences and possible interventions of GBD are discussed.

Methods

Female medical students (n=235) and female physicians (n=157) from five university hospitals in northern Germany were asked about their personal experiences with GBD in an online survey on self-efficacy expectations and individual perceptions of the "glass ceiling effect" using an open-ended question regarding their own experiences with GBD. The answers were analyzed by content analysis using inductive category formation and relative category frequencies.

Results

From both interviewed groups, approximately 75% each reported having experienced GBD. Their experiences fell into five main categories: sexual harassment with subcategories of verbal and physical, discrimination based on existing/possible motherhood with subcategories of structural and verbal, direct preference for men, direct neglect of women, and derogatory treatment based on gender.

Conclusion

The study contributes to filling the aforementioned research gap. At the hospitals studied, GBD is a common phenomenon among both female medical students and physicians, manifesting itself in multiple forms. Transferability of the results beyond the hospitals studied to all of Germany seems plausible. Much is known about the causes, consequences and effective countermeasures against GBD. Those responsible for training and employers in hospitals should fulfill their responsibility by implementing measures from the set of empirically evaluated interventions.

Inadequate treatment in internships: a comparison between medical and other students

Aims: Inadequate treatment is one of the factors interfering with a successful social and working life. Among students, it can impair their health and learning progress. In the field of medicine the problem of inadequate treatment seems widespread. This study examines wether inadequate treatment in internships differs between medicine and other academic disciplines. Method: Using a questionnaire, the frequency, forms and severity of inadequate treatment among students were compared between the disciplines of medicine, civil engineering and teaching. Results: 69,3% of medical students reported inadequate treatment during their internships, about twice as many as students of other disciplines. The ratios of verbal, non-verbal and organisational inadequate treatment were similar between the different academic disciplines. However, medical students executed tasks without receiving sufficient safety precautions or training significantly more often (sevenfold) than students of other disciplines. In total however, the experienced incidents of inadequate treatment were seen as similarly severe across the different academic fields. Conclusion: Inadequate treatment of students during internships is a larger problem in medicine than in civil engineering or teaching, particularly concerning the performance of unsafe tasks. With regard to the health of students and patients, inadequate treatment in the medical education should be tackled. Previous studies suggest that this goal can be achieved only through longtime extensive measures on the level of students, lecturers, faculty and teaching hospitals.

Medical students' experiences with sexual discrimination and perceptions of equal opportunity: a pilot study in Germany

BACKGROUND

Data is available on sexual discrimination and subjective perceptions of equal opportunity in medical education for many countries. Surveys focussing on sexual harassment have not yet been conducted at German medical schools.

METHODS

A student initiative surveyed all medical students at the Hannover Medical School (MHH) using an anonymous online questionnaire on equal opportunity and sexual discrimination to identify potential problems in education.

RESULTS

A total of 343 students (15%) participated in the survey. Over 50% reported having either witnessed sexual harassment or experienced it themselves. Female students indicated having experienced sexual harassment three times more often than their male peers; verbal forms of sexual discrimination predominate. These observations and experiences of sexual harassment demonstrated significant influences on many perceptions regarding equal opportunity and equal treatment in the MHH undergraduate medical education at MHH.

CONCLUSION

This blind spot in medical education in the German-speaking countries should be scrutinized more closely. The experience of sexism in the context of undergraduate medical education, which has negative effects on students, should no longer be ignored in empirical education research.

Gender differences and similarities in medical students' experiences of mistreatment by various groups of perpetrators

BACKGROUND

Mistreatment of medical students during medical education is a widespread concern. Studies have shown that medical students report the most mistreatment compared to students of other study programs and that the prevalence of mistreatment peaks during clinical training. For this reason, a study was conducted to assess prevalence of mistreatment among medical students committed by various groups of people. The focus was to identify whether gender was associated with the experience of mistreatment. Additionally, students' perception of university climate for reporting sexual harassment was assessed.

METHOD

In the study 88 medical students (45 women, 43 men) participated. A modified version of the Questionnaire on Student Abuse was used to assess students' experience of various types of mistreatment and associated distress during medical education. To explore factors that could be associated with this experience the organizational climate for reporting sexual harassment was assessed with the Psychological Climate for Sexual Harassment.

RESULT

The most often cited perpetrators of mistreatment were strangers (79.5%), friends (75.0%) and university staff (68.2%). Strangers mostly committed psychological mistreatment and sexual harassment, whereas friends additionally engaged in physical mistreatment of medical students. The most common form of mistreatment conducted by university staff was humiliation of students. These kinds of psychological mistreatment were reported to be distressing (43%). Gender differences were found in the prevalence of mistreatment. Women experienced more sexual harassment and humiliation than did men. On the other hand, men experienced more physical mistreatment than did women. Women reported experiencing more distress from mistreatment experiences than did men and also more often reported being mistreated by university staff than did men. Women perceived a greater risk in reporting sexual harassment to the organization than did men.

CONCLUSION

Mistreatment of female and male students should be focused on using a gender perspective because types of mistreatment can differ by gender. Additionally, interventions should include the societal level as there was a high prevalence of mistreatment perpetrated by strangers. Also the issue of trust in the university needs to be addressed and the organization is called on to visibly demonstrate that it represents and protects its students as well as its staff.

Bullying and Victimization Trends in Undergraduate Medical Students - A Self-Reported Cross-Sectional Observational Survey

INTRODUCTION

Bullying is a form of behaviour that can negatively impact a person. It can lead to several deleterious consequences like low self-confidence, drop in academic performance and depression. Studies have shown that bullying behaviour exists amongst medical students also. In the medical field, it is known to negatively impact dispensing of health care and attitudes of medical students towards becoming doctors. It is very difficult for medical students to cope with such a menace as they are already burdened with a vast curriculum and rigorous schedules. There exists paucity of studies regarding bullying amongst undergraduate medical students in Indian context.

AIM

To study prevalence of peer-based bullying and victimization along with their associated factors in undergraduate medical students.

MATERIALS AND METHODS

Four hundred randomly chosen undergraduate medical students were included in the study. Socio-demographic and personal details including history of substance use were recorded in a self-designed case record form. Illinois Bullying Scale was used to assess bullying behaviours. Out of total 400 students, 383 completed the survey and this data was analysed.

RESULTS

In this study, 98.69% participants self-reported to having indulged in bullying while 88.77% reported feeling victimized. Physical (p<0.001) as well as verbal (p=0.001) bullying was found to be of significantly greater severity in males as compared to females. Students of the third year of medical school indulged in significantly (p=0.034) greater severity of physical bullying than those of other years. Alcohol consumption (p=0.001) and cigarette smoking (p<0.001) were significantly associated with physical bullying.

CONCLUSION

Peer-based bullying and victimization was found to be highly prevalent amongst undergraduate medical students. There is an urgent need for more detailed studies on bullying in medical students so that remedial measures can be initiated and steps to limit such behaviours can be looked at seriously.