Pilot study on the prevalence of abuse and mistreatment during clinical internship: a cross-sectional study among first year residents in Oman

Musculoskeletal pain among medical residents: role of workplace safety climate and sexual harassment

BACKGROUND

Workplace factors are important predictors of occurrence of musculoskeletal pain among different occupational populations. In healthcare, a psychologically unsafe work environment can negatively affect the emotional, physical and psychological well-being of physicians. This study aimed to examine the relationship between workplace violence, sexual harassment and musculoskeletal pain among Egyptian physicians in their years of residency.

METHODS

We distributed an online self-administered questionnaire to 101 residents working in various healthcare sectors in Egypt. It included sections on demographic data, working conditions, widespread pain index (WPI), pain interference short-form, workplace violence and harassment questionnaire, psychosocial safety climate questionnaire (PSC) and sexual harassment climate questionnaire.

RESULTS

All residents had at least one painful site on the WPI (range 1-11). The mean WPI was 3.5 ± 2.4, and 39.6% satisfied the criteria of having widespread pain by having at least 4 pain sites. Widespread pain index showed a weak statistically significant negative correlation with workplace PSC score (rho = - 0.272, p = 0.006), and a statistically significant weak positive correlation with the calculated total abuse index (rho = 0.305, p = 0.002). Workplace violence and abuse, as measured by a calculated abuse index was the only significant predictors of widespread pain among residents.

CONCLUSION

WPV was found to be a predictor of musculoskeletal pain among medical residents. Healthcare organizations need to address WPV by employing preventive strategies to minimize its hazardous effects and ensure a safe working environment for physicians.

Medical Students' Experiences of Mistreatment by Clinicians and Academics at a South African University

Phenomenon: Tertiary education in post-apartheid South Africa has faced many challenges regarding class, language, and race. Even though previously white Afrikaans-rooted universities now have a diverse student population, recent student protests have highlighted the ongoing need for decolonization in higher education. In addition, the majority of public hospitals in the country function under significant staffing, infrastructure, and equipment shortages. Although the mistreatment of medical students has been well described internationally, to date no South African data exists. The aim of this study was to identify experiences of mistreatment of medical students by clinicians and academics at a South African university and to describe the type of mistreatment experienced, the perceived mental health effects, and the influence on academic performance, resilience, and students' knowledge of current reporting systems. Approach: A cross-sectional study was conducted through a locally developed online survey of 443 medical students at a South African university in May to June 2018, comprising of both open and closed ended questions. Levels of psychological distress (K10) and resilience (CD-RISC -10) were measured. Chi-square and student t-tests were used for the analysis of associations, and linear regressions were used to assess predictors of psychological distress. Qualitative data were analyzed thematically using the approach described by Braun and Clarke. Findings: Of 800 eligible medical students at Stellenbosch University, 443 students (55.4%) completed the survey. Mistreatment, comprising of being ignored/excluded (83.4%), offensive gestures (75.0%), verbal abuse (65.1%) and discrimination (64.4%), was prevalent and pervasive, and was perpetrated mainly by registrars (46.7%) and other medical staff (43.8%). Mistreatment was associated with psychological distress, which was generally high and more severe for females. Resilience, which was higher for males, moderated the effects of gender and perpetrator type on distress. Only 15% of students who had experienced mistreatment, either directly or indirectly, reported it, of which more than half (52.8%) were not happy with the outcome. Most students (80.9%) were not aware of the systems in place to report mistreatment. Insights: Student mistreatment is more highly prevalent among medical students at a South African university compared with studies conducted internationally. Despite over 20 years of democracy in South Africa, high rates of racial and gender discrimination were reported and descriptions of racial, language and gender discrimination were particularly concerning. Since the findings of this study, an anti-bullying poster-campaign has been initiated at the university as well as an online reporting system.

Impact of workplace violence on anxiety and sleep disturbances among Egyptian medical residents: a cross-sectional study

BACKGROUND

Workplace violence (WPV) against healthcare workers is a common occurrence worldwide, especially among young physicians and medical residents. This study aimed to explore the negative health impacts of WPV among medical residents in Egypt, and their perception regarding how safe it is to report violence.

PURPOSE

To investigate the prevalence of WPV among medical residents, its possible negative health impacts, specifically on sleep quality and mental health, and the perceived workplace safety climate.

METHODS

This is a cross-sectional analytic study, using a convenience sample through an online questionnaire. An abuse index was calculated, generalized anxiety disorder (GAD) and sleep quality were collected from the reported outcomes.

RESULTS

The study sample included 101 residents (86.1% females). The most common reported form of abuse was verbal abuse, with the most common reported perpetrators being senior staff members (59.4%). About 86% of participants were classified as poor sleepers, while 59.4% had GAD, and there were significant positive correlations between GAD and Global Pittsburgh Sleep Quality Index (PSQI) scores with the abuse index. More than one third (35.6%) of residents reported a very high-risk Psychosocial Safety Climate (PSC) score, and 31.6% of them either strongly agreed or agreed that reporting a sexual harassment claim would be dangerous.

CONCLUSION

Workplace violence is common among Egyptian medical residents, with a significant negative impact on sleep quality and a rising risk of GAD. The promotion of a safe workplace environment is essential in protecting the health and wellbeing of medical residents.

The prevalence and factors associated with anxiety symptoms among resident physicians in Oman: a cross-sectional study

Background

Anxiety disorders are a significant factor associated with physician burnout and poor patient care, reported to have a significant frequency among the youth in the Middle East. However, to date, no study has explored the prevalence of anxiety among resident physicians in the Arabian Gulf country of Oman. This cross-sectional study, conducted among a random sample of residents affiliated with the Oman Medical Specialty Board, aimed to examine the frequency and factors associated with anxiety symptoms among them. Participants were asked to complete the General Anxiety Disorder Assessment (GAD-7) to assess anxiety, as well as a socio-demographic questionnaire.

Results

In a total of 251 residents, the prevalence of anxiety was 14.7% (GAD-7 cut-off score ≥ 10). More than 60% of the respondents were female (68.9%). The age breakdown ranged from 25 to 30 years old (66.5%) and the majority were married (64.9%). More than 70% of respondents attended at least 5 shifts in their weekly schedule and received at least 5 on-call shifts from the hospital per week. Logistic regression showed that residents with chronic disease were 2.5 times (95% CI 1.36–4.72, p = 0.003) more likely to have anxiety than those without them. Those residents who did not exercise were 2.1 times (95% CI 1.04–4.46, p = 0.038) more likely to have anxiety than those who exercise often or regularly. Residents who received 6 or more on-calls from the hospital were 2.6 times (95% CI 1.35–5.25, p = 0.005) more likely to have anxiety than those who received 5 or fewer on-calls in a month.

Conclusions

The factors seemingly responsible for anxiety symptoms in this sample of resident physicians are those that are typically associated with poor work-life balance and unhealthy lifestyles. Pending further scrutiny, these results could be used to lay the groundwork for the identification of those who will require more protracted help during their training in Oman and in other culturally similar Middle Eastern countries.

Discrimination, harassment, and intimidation amongst otolaryngology: head and neck surgeons in Canada

BACKGROUND

Understanding mistreatment within medicine is an important first step in creating and maintaining a safe and inclusive work environment. The objective of this study was to quantify the prevalence of perceived workplace mistreatment amongst otolaryngology-head and neck surgery (OHNS) faculty and trainees in Canada.

METHODS

This national cross-sectional survey was administered to practicing otolaryngologists and residents training in an otolaryngology program in Canada during the 2020-2021 academic year. The prevalence and sources of mistreatment (intimidation, harassment, and discrimination) were ascertained. The availability, awareness, and rate of utilization of institutional resources to address mistreatment were also studied.

RESULTS

The survey was administered to 519 individuals and had an overall response rate of 39.1% (189/519). The respondents included faculty (n = 107; 56.6%) and trainees (n = 82; 43.4%). Mistreatment (intimidation, harassment, or discrimination) was reported in 47.6% of respondents. Of note, harassment was reported at a higher rate in female respondents (57.0%) and White/Caucasian faculty and trainees experienced less discrimination than their non-White colleagues (22.7% vs. 54.5%). The two most common sources of mistreatment were OHNS faculty and patients. Only 14.9% of those experiencing mistreatment sought assistance from institutional resources to address mistreatment. The low utilization rate was primarily attributed to concerns about retribution.

INTERPRETATION

Mistreatment is prevalent amongst Canadian OHNS trainees and faculty. A concerning majority of respondents reporting mistreatment did not access resources due to fear of confidentiality and retribution. Understanding the source and prevalence of mistreatment is the first step to enabling goal-directed initiatives to address this issue and maintain a safe and inclusive working environment.

Prevalence and Impact of Academic Violence in Medical Education

Situations of mistreatment in the academic environment are prevalent worldwide, but research in this area is scarce in middle-low-income countries. This study aimed to estimate the prevalence of mistreatment inflicted against Brazilian medical students. In addition, characterize these situations and analyze their consequences. Cross-sectional study conducted with 831 medical students from public and private institutions. Absolute and relative frequencies of the analyzed variables and possible associations were determined through univariate and multivariate logistic regression. Chi-square test of association with second-order Rao-Scott adjustment was also used. The response rate was 56%. Public institution pointed to a higher prevalence of mistreatment when compared to private (59% versus 43%). Female students were the most affected. Verbal and psychological aggression was more prevalent. The aggressor usually was a faculty member. Mistreatment incidence increased over the years of training, with higher rates in the internship. About 94% of the students felt affected in anyway, with 77% feeling diminished and depressed. More than 50% reported impaired academic performance. Almost 30% sought help from experts. The reporting rate was extremely low. Adequate identification of the situations by the victims, safe reporting mechanisms and, an educational system capable of maintaining an appropriate learning environment are essential to break this destructive cycle.

Transitional challenges faced by medical intern doctors (IDs) in Vanuatu: a qualitative study

The transition from being a medical student to a fully qualified registered doctor is a challenging time in the lives of intern doctors (IDs). Throughout those challenging times they face many challenges which significantly impact their professional lives as well as their transitional experience. This study aimed to identify the transitional challenges experienced by IDs in Vanuatu. This qualitative study was conducted using a phenomenological approach whereby data collection is done through semi-structured in-depth interviews. Ethical approval was obtained before the commencement of this study. Twenty-seven participants were IDs of Vila Central Hospital and Northern Provincial Hospital in Vanuatu who were either current IDs and had worked for more than 6 months or had completed internship within the past 2 years. The willing IDs were consented on paper before they participated in the interview. The interview data was then transcribed verbatim and interpreted thematically. The participating IDs in the study were between the ages of 27 and 36 years old. Twenty two were current interns while the remaining five had recently completed their internship and now working as registered doctors. Three subthemes were identified as challenges through thematic analysis in this study; intern's welfare not met; different medical training institution; and transitional shock. Those subthemes were later categorized. The study findings have identified that intern's welfare needs improvement along with diverse training medical schools, and the transitional internship encounters were significant challenges experienced by IDs. There is indeed a need for healthcare providers, medical leaders, and relevant stakeholders to recognize and address these challenges.

Systematic review of academic bullying in medical settings: dynamics and consequences

PURPOSE

To characterise the dynamics and consequences of bullying in academic medical settings, report factors that promote academic bullying and describe potential interventions.

DESIGN

Systematic review.

DATA SOURCES

We searched EMBASE and PsycINFO for articles published between 1 January 1999 and 7 February 2021.

STUDY SELECTION

We included studies conducted in academic medical settings in which victims were consultants or trainees. Studies had to describe bullying behaviours; the perpetrators or victims; barriers or facilitators; impact or interventions. Data were assessed independently by two reviewers.

RESULTS

We included 68 studies representing 82 349 respondents. Studies described academic bullying as the abuse of authority that impeded the education or career of the victim through punishing behaviours that included overwork, destabilisation and isolation in academic settings. Among 35 779 individuals who responded about bullying patterns in 28 studies, the most commonly described (38.2% respondents) was overwork. Among 24 894 individuals in 33 studies who reported the impact, the most common was psychological distress (39.1% respondents). Consultants were the most common bullies identified (53.6% of 15 868 respondents in 31 studies). Among demographic groups, men were identified as the most common perpetrators (67.2% of 4722 respondents in 5 studies) and women the most common victims (56.2% of 15 246 respondents in 27 studies). Only a minority of victims (28.9% of 9410 victims in 25 studies) reported the bullying, and most (57.5%) did not perceive a positive outcome. Facilitators of bullying included lack of enforcement of institutional policies (reported in 13 studies), hierarchical power structures (7 studies) and normalisation of bullying (10 studies). Studies testing the effectiveness of anti-bullying interventions had a high risk of bias.

CONCLUSIONS

Academic bullying commonly involved overwork, had a negative impact on well-being and was not typically reported. Perpetrators were most commonly consultants and men across career stages, and victims were commonly women. Methodologically robust trials of anti-bullying interventions are needed.

LIMITATIONS

Most studies (40 of 68) had at least a moderate risk of bias. All interventions were tested in uncontrolled before-after studies.

Workplace Violence Among Healthcare Workers in a Tertiary Medical City in Riyadh: A Cross-Sectional Study

Introduction

Workplace violence is a common problem that is encountered by healthcare workers worldwide; however, it is still under-studied in Saudi Arabia. This study aims to determine the prevalence of workplace violence and to explore reasons for not reporting it among healthcare workers in a tertiary medical city in Riyadh.

Methods

This cross-sectional study was conducted among 404 healthcare workers who had direct contact with patients or their relatives in a tertiary care medical city in Riyadh, Saudi Arabia. Data were analyzed using Statistical Analysis Software Package (SPSS; IBM, Armonk, NY, USA).

Results

Most participants (81.4%) had experienced verbal, physical, academic, or sexual violence. Approximately 39.6% of those who experienced workplace violence did not report the incident, and the most common reason for not reporting was identified as “reporting would not accomplish anything” (49.4%). About 27.5% of violence victims did not know how to report the incidents. Patients or their relatives were the main sources of violence across all violence categories except academic violence, in which consultant physicians were the main source.

Conclusions

The prevalence of workplace violence in the population studied was higher than anticipated compared to similar studies both in Saudi Arabia and globally. Almost half of those who were subjected to violence did not report the incident, believing that reporting would not change anything. There is arguably an urgent need to develop strategies that reduce workplace violence and facilitate reporting it in hospitals. Moreover, awareness programs regarding the negative impacts of violence against healthcare workers on the quality of care are necessary.

Workplace Bullying Among Junior Doctors in Malaysia: A Multicentre Cross-Sectional Study

Background

Research suggests that junior doctors often experience workplace bullying, which may have adverse impacts on medical training and delivery of quality healthcare. However, evidence among local population has not been established. The present study aims to examine the prevalence of workplace bullying among Malaysian junior doctors and explore its associated sociodemographic and employment factors.

Methods

A multicentre cross-sectional study was conducted in 12 government hospitals accredited for housemanship training within the central zone of Malaysia. The study included a total of 1,074 house officers who had been working for at least 6 months in various housemanship rotations. The Negative Acts Questionnaire-Revised (NAQ-R) was used to examine workplace bullying.

Results

The 6-month prevalence of workplace bullying among study participants was 13%. Work-related bullying such as ‘being ordered to do work below your level of competence’, person-related bullying such as ‘being humiliated or ridiculed in connection with your work’, and physically intimidating bullying such as ‘being shouted at or being the target of spontaneous anger’ were commonly reported by study participants. Medical officers were reported to be the commonest perpetrators of negative actions at the workplace. Study participants who graduated from Eastern European medical schools (adjusted odds ratio [AOR] 2.27; 95% confidence interval [CI]: 1.27, 4.07) and worked in surgical-based rotation (AOR 1.83; 95% CI: 1.13, 2.97) had higher odds of bullying compared to those who graduated from local medical schools and worked in medical-based rotation, whereas study participants with good English proficiency (AOR 0.14; 95% CI: 0.02, 0.94) had lower odds of bullying compared to those with poor English proficiency.

Conclusion

The present study shows that workplace bullying is prevalent among Malaysian junior doctors. Considering the gravity of its consequences, impactful strategies should be developed and implemented promptly in order to tackle this serious occupational hazard.

[Mistreatment of students and associated factors in the Faculty of Medicine of Parakou in 2018]

Introduction

Plusieurs études à travers le monde ont montré l'importante survenue des comportements de maltraitance subis par les étudiants en médecine. Notre objectif a été d'étudier les comportements de maltraitance subis par les étudiants et les facteurs associés au sein de la Faculté de Médecine de Parakou (FM/UP) en 2018.

Méthodes

Une enquête transversale descriptive et analytique a été conduite du 1^er au 28 février 2018 chez les étudiants de la FM/UP. Les participants étaient les étudiants en 2^ème année médecine (PCEM2), en 4^ème année de médecine (DCEM2) et en 6^ème année de médecine (DCEM4) inscrits au titre de l'année universitaire 2017-2018 qui ont librement donné leur consentement éclairé pour participer à l'étude.

Résultats

Cent pourcent des étudiants de la FM/UP avaient subi au moins une fois un comportement de maltraitance. Les étudiants subissaient fréquemment un comportement de maltraitance dans 34,34% des cas. L'humiliation, la violence verbale et le fait d'être amené à effectuer un service personnel étaient les formes de violences les plus subies. Cependant, environ 10% des étudiants ont subi un harcèlement sexuel. Les auteurs de ces comportements de maltraitance subis par les étudiants étaient d'abord les médecins/enseignants, et les infirmiers puis les internes. Les étudiantes étaient trois fois plus harcelées sexuellement que leurs camarades du sexe opposé (p=0,0069). Plus les étudiants étaient âgés et inscrits au deuxième cycle des études médicales, plus ils subissaient l'humiliation (p=0,0001 pour l'âge et p<0,0001 pour le niveau d'étude) et la violence verbale (p=0,0007 pour l'âge et p<0,0001 pour le niveau d'étude).

Conclusion

Cette étude a permis de montrer que tous les étudiants de la FM/UP ont subi au moins une fois un comportement de maltraitance depuis leur inscription dans l'université. Cette étude offre l'opportunité aux responsables de l'université de mettre en place une stratégie de communication pour un changement de comportement des enseignants et encadrants par rapports aux comportements de maltraitance. L'initiative d'un registre de plaintes serait également utile pour réduire l'ampleur du phénomène.

Psyche Meets the Gatekeepers: Creating a More Humane Culture for Women in Medicine

In the Greek myth of Psyche and Eros, Psyche must fulfill four seemingly impossible tasks to achieve full consciousness before she can be reunited with her bridegroom, Eros. From early childhood, girls and women can encounter gender stereotyping, sexual harassment and assault, and other gender-related challenges. Although both men and women can face mistreatment in medical school, female students experience sexual harassment and sexual assault at higher rates than male students. In medical training and career advancement, women often face additional obstacles unrelated to the formal education of physicians, such as salary and promotional disparities, and lack of mentorship, sponsorship, or role models. The suicide rate for male physicians is nearly 1.5 times higher than the general population; for female physicians, it is more than twice as high. Parenthood can pose additional challenges for mothers and fathers early in their academic careers, and women are vastly underrepresented as they try to move past the "gatekeepers" into leadership roles. Using the framework of the Psyche and Eros myth to examine the trajectory of a female physician's career, this article provides insights into these challenges, as well as strategies to address some of these inequities, such as programs to support female promotion and leadership, expanded mentorship and mentor models, sponsorship opportunities, leadership accountability, implicit bias training, and others. The authors call for the participation of both men and women as essential in ventures to create a more humane environment for the training and practice of medicine.

Organisational antecedents of workplace victimisation: The role of organisational climate, culture, leadership, support, and justice in predicting junior doctors' exposure to bullying at work

Workplace bullying is a pervasive phenomenon among junior doctors that may negatively impact their training and abilities to deliver quality healthcare, yet evidence on the factors of bullying among them remains lacking. This study examined the role of organisational climate, culture, leadership, support, and justice in junior doctors' exposure to workplace bullying on the basis of the work environment hypothesis, which suggests that workplace psychosocial factors are the main antecedents of bullying at work. Multilevel analysis of a universal sample (n = 1074) of junior doctors working in the central zone of Malaysia, using mixed effects logistic regression, was conducted. Analysis indicates that junior doctors working in departments with neutral and positive organisational climate, moderate and high degree of clan culture, moderate and high degree of adhocracy culture, moderate degree of hierarchy culture, moderate degree of production and achievement-oriented leadership style, moderate and high degree of organisational support, moderate degree of procedural justice, moderate and high degree of interactional justice, and high degree of distributive justice have lower odds of bullying compared with their counterparts. The results present evidence that all aspects of the organisation influence junior doctors' exposure to bullying and should be considered when developing antibullying initiatives targeted at them.

Medical student mistreatment by patients in the clinical environment: prevalence and management

INTRODUCTION

Medical students rely on patients and their families as teachers during the learning journey. However, ill patients and their families may not welcome having students participating in their care, and anecdotal instances of abuse against clinical medical students are not uncommon. We aimed to determine the prevalence of medical student mistreatment by patients and their families and describe students' self-reported responses to such incidents.

METHODS

An email link to an anonymised electronic survey form was sent to all clinical students (n = 184) at a Singapore medical school. The first part of the survey sought information on whether the student had previous experiences of mistreatment by patients and their families. If so, the frequency of mistreatment, circumstances when mistreatment happened and students' reactions were collected. In the second part, the students were asked if they knew how to handle such mistreatment incidents.

RESULTS

There were a total of 91 respondents, 14.3% of whom had experienced mistreatment by patients and their families in our institution. One-third of the affected students felt fearful or humiliated. However, the majority chose to be passive by saying nothing or moving away. Less than half of the students knew how to handle such incidents or where to seek help.

CONCLUSION

Incidents of mistreatment in our school are not uncommon. Our study revealed a need for more clarity and guidance about how students can manage such situations. This is an important topic because such mistreatment is known to inflict emotional disturbance in students. We proposed a workflow to help students deal with mistreatment.

Bullying and Sexual Discrimination in the Greek Health Care System

INTRODUCTION

Modern medicine is based on teamwork and communication. Bullying and discrimination can have a serious effect on these, affecting the standard of medical training and patient care.

AIM

To determine the incidence of bullying and sex discrimination in the Greek health care system.

METHODS

An online questionnaire was designed and circulated among Greek medical professionals.

RESULTS

We received 1349 completed questionnaires with a response rate of 48% and with 45% of them being female. Equal opportunities in specialty training were reported by 55% of the participants. Female doctors in medicine and in surgery reported no equal opportunities at an incidence of 15% and 30%, respectively (p < 0.001). Family obligations and lack of family support were considered as the main obstacles in female doctors' professional development by 92% and 59% of the participants, respectively. Both sexes appeared to have suffered from various forms of abusive behavior with characteristics that vary between them. Verbal abuse, threatening behavior, and sexual harassment were reported by 50%, 38%, and 20%, respectively, with women being 3 times more likely to be victims of sexual harassment (34% vs. 9%, p < 0.001). Finally, the availability of official support mechanisms was reported in only 15% of the cases, whereas friends and colleagues were the main support for 46.17% of the cases.

CONCLUSION

This is the first study attempting to preliminary describe the extent of bullying and sexual discrimination in the Greek national health care system. Despite the limitations of this study, it is imperative that more research is performed on this issue from the appropriate national authorities.

Medical internship training in Saudi Arabia: interns' views and perceptions

BACKGROUND

Internship training offers an important opportunity for personal development and career planning. However, there are many factors affecting the efficiency of training, and the views of interns are rarely considered. The main objective of this study was to explore the views of interns enrolled in Jazan University internship program during the year 2015.

SUBJECTS AND METHODS

A web-based cross-sectional study was conducted in the Jazan region, Kingdom of Saudi Arabia, during the academic year 2015. To achieve the study goals, an online questionnaire was distributed to all interns (n=85) enrolled in the Jazan University internship program.

RESULTS

Results revealed that satisfaction with training was more evident in general surgery and pediatrics (76.1%, n=54 and 77.5%, n=55, respectively). Satisfaction was lowest for obstetrics and gynecology programs (45.1%, n=32), while in internal medicine it was 54.9% (n=39). Training in general surgery and pediatrics was rated as excellent by most of the interns (45.8% and 43.1%, respectively). The picture is reversed in obstetrics and gynecology, as 43.1% rated it as average. More than half of the study sample felt that they were well prepared to start the next step in their career at the end of internship (50.7%), while 25.4% felt that they were moderately prepared.

CONCLUSION

It is clear that training quality in views of interns is variable across the major specialties, and there are some problems in obstetrics and gynecology training. More studies are needed to explore in-depth dimensions of internship training program in the Kingdom of Saudi Arabia.

Altering workplace attitudes for resident education (A.W.A.R.E.): discovering solutions for medical resident bullying through literature review

BACKGROUND

Physicians-in-training are challenged every day with grueling academic requirements, job strain, and patient safety concerns. Residency shapes the skills and values that will percolate to patient care and professional character. Unfortunately, impediments to the educational process due to medical resident mistreatment by bullying remain highly prevalent in training today.

METHODS

A PubMed literature review was undertaken using key terms to help define resident mistreatment by bullying, determine its prevalence, identify its potential causes and sequelae, and find suggestions for changing this detrimental culture of medical training.

RESULTS

We identified 62 relevant articles. The most frequently noted form of mistreatment was verbal abuse, with the most common perpetrators being fellow physicians of higher hierarchical power. Mistreatment exists due to its cyclical nature and the existing culture of medical training. These disruptive behaviors affect the wellbeing of both medical residents and patients.

CONCLUSIONS

This article highlights the importance of creating systems that educate physicians-in-training about professional mistreatment by bullying and the imperative in recognizing and correcting these abuses. Resident bullying leads to increased resident stress, decreased resident wellbeing as well as risks to patient safety and increased healthcare costs. Solutions include education of healthcare team members, committee creation, regulation of feedback, and creation of a zero-tolerance policy focused on the health of both patients and residents. Altering workplace attitudes will diminish the detrimental effects that bullying has on resident training.

Interns' perceived abuse during their undergraduate training at King Abdul Aziz University

BACKGROUND AND OBJECTIVES

Abuse occurs in all workplaces, including the medical field. The aim of this study was to determine the prevalence of perceived abuse among medical students, the types of abuse experienced during medical training, the source of abuse, and the perceived barriers to reporting abuse.

METHOD

This cross-sectional survey was conducted between September 2013 and January 2014 among medical graduates of King Abdul Aziz University, Jeddah. The survey questionnaire was designed to gather information regarding the frequency with which participants perceived themselves to have experienced abuse, the type of abuse, the source of abuse, and the reasons for nonreporting of perceived abuse. Data were analyzed using the Statistical Package for the Social Sciences.

RESULT

Of the 186 students enrolled in this study, 169 (90.9%) reported perceiving some form of abuse during medical school training. Perceived abuse was most often verbal (86.6%), although academic abuse (73.1%), sex discrimination (38.7%), racial or ethnic discrimination (29.0%), physical abuse (18.8%), religious discrimination (15.1%), and sexual harassment (8.6%) were also reported. Professors were most often cited as the sources of perceived abuse, followed by associate professors, demonstrators (or assistant teaching staff), and assistant professors. The Internal Medicine Department was the most frequently cited department where students perceived themselves to have experienced abuse. Only 14.8% of the students reported the abuse to a third party.

CONCLUSION

The self-reported prevalence of medical student abuse at King Abdul Aziz University is high. A proper system for reporting abuse and for supporting victims of abuse should be set up, to promote a good learning environment.