A Mixed-Methods Analysis of a Novel Mistreatment Program for the Surgery Core Clerkship

Acad Med. 2017 Jul;92(7):1028-1034. doi: 10.1097/ACM.0000000000001575.

Abstract

Purpose: To review mistreatment reports from before and after implementation of a mistreatment program, and student ratings of and qualitative responses to the program to evaluate the short-term impact on students.

Method: In January 2014, a video- and discussion-based mistreatment program was implemented for the surgery clerkship at the Stanford University School of Medicine. The program aims to help students establish expectations for the learning environment; create a shared and personal definition of mistreatment; and promote advocacy and empower ment to address mistreatment. Counts and types of mistreatment were compared from a year before (January-December 2013) and two years after (January 2014-December 2015) implementation. Students' end-of-clerkship ratings and responses to open-ended questions were analyzed.

Results: From March 2014-December 2015, 141/164 (86%) students completed ratings, and all 47 (100%) students enrolled from January-August 2014 provided qualitative program evaluations. Most students rated the initial (108/141 [77%]) and final (120/141 [85%]) sessions as excellent or outstanding. In the qualitative analysis, students valued that the program helped establish expectations; allowed for sharing experiences; provided formal resources; and provided a supportive environment. Students felt the learning environment and culture were improved and reported increased interest in surgery. There were 14 mistreatment reports the year before the program, 9 in the program's first year, and 4 in the second year.

Conclusions: The authors found a rotation-specific mistreatment program, focused on creating shared understanding about mistreatment, was well received among surgery clerkship students, and the number of mistreatment reports decreased each year following implementation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • California
  • Clinical Clerkship / organization & administration*
  • Curriculum*
  • Education, Medical, Undergraduate / organization & administration*
  • Female
  • General Surgery / education*
  • Humans
  • Interpersonal Relations*
  • Male
  • Students, Medical / psychology*
  • Young Adult