Experiences of belittlement and harassment and their correlates among medical students in the United States: longitudinal survey
Experiences of belittlement and harassment and their correlates among medical students in the United States: longitudinal survey
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DOI：
10.1136/bmj.38924.722037.7c
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发表时间：
2006-09-30
影响因子：
105.7
通讯作者：
Nora, Lois Margaret
中科院分区：
文献类型：
--
作者：
Frank, Erica;Carrera, Jennifer S.;Nora, Lois Margaret
目的了解医学生被骚扰或被轻视的知觉及其相关因素，为减少此类虐待提供依据。设计纵向调查方法：设置16所具有全国代表性的美国医科学校，2003级2884名学生。主要测量新生入学时、入院时、大四时其他学生、住院医师或研究员、临床前教授、临床教授或主治医师、病人骚扰和轻视的经历。在老年人中，42%(581/1387)的人报告在医学院期间经历过骚扰，84%(1166/1393)的人曾受到轻视。这些类型的虐待是由其他学生造成的(分别有11%(158/1389)和32%(443/1390)的学生经历过此类骚扰或轻视)。骚扰和轻视还包括居民(27%(374/1387)和71%(993/1393))、临床前教授(9%(131/1386)和29%(398/1385))、临床教授(21%(285/1386)和63%(878/1390))和病人(25%(352/1387)和43%(592/1388))。只有13%(181/1385)的学生将这些经历中的任何一种归类为严重。报告受到骚扰或轻视的医学生与没有报告此类经历的学生在性别、种族、政治取向或宗教方面没有显著差异。他们确实在所选专业上存在显著差异，而且更有可能感到压力、抑郁和自杀，饮酒或酗酒，并表示他们的教职员工不关心医科学生。他们也不太可能很高兴他们被训练成为一名医生。结论大多数美国医学生报告在他们的训练过程中受到骚扰或轻视。虽然很少有学生将骚扰或轻视描述为严重的，但心理健康状况不佳和职业满意度低与这些经历显著相关。
Objective To determine medical students' perceptions of having been harassed or belittled and their correlates, for the purposes of reducing such abuses.Design Longitudinal survey.Setting 16 nationally representative US medical schools.Participants 2884 students from class of 2003.Main outcome measures Experiences of harassment and belittlement at freshman orientation, at entry to wards, and in senior year by other students, by residents or fellows, by preclinical professors, by clinical professors or attendings, or by patients.Results 2316 students provided data (response rate 80.3%). Among seniors, 42% (581/1387) reported having experienced harassment and 84% (1166/1393) belittlement during medical school. These types of abuse were caused by other students (11% (158/1389) and 32% (443/1390) of students experienced such harassment or belittlement, respectively). Harassment and belittlement was also caused by residents (27% (374/1387) and 71% (993/1393)), preclinical professors (9% (131/1386) and 29% (398/1385)), clinical professors (21% (285/1386) and 63% (878/1390)), and patients (25% (352/1387) and 43% (592/1388)). Only 13% (181/1385) of students classified any of these experiences as severe. Medical students who reported having been harassed or belittled did not differ significantly from those not reporting such experiences by sex, ethnicity, political orientation, or religion. They did differ significantly by chosen specialty and were significantly more likely to be stressed, depressed, and suicidal, to drink alcohol or to binge drink, and to state that their faculty did not care about medical students. They were also significantly less likely to be glad they trained to become a doctor.Conclusion Most medical students in the United States report having been harassed or belittled during their training. Although few students characterised the harassment or belittlement as severe, poor mental health and low career satisfaction were significantly correlated with These experiences.