MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There are numerous articles that clearly document the high prevalence of mistreatment of medical trainees. We have all seen and experienced the results of an “I’ll do unto you like they did unto me” attitude towards medical education. Our motivation for this study was to go beyond just documenting the problem, and start looking at what people are doing to help fix it.
Unfortunately, we found that there are comparatively few reports of programs dedicated to preventing or decreasing mistreatment of medical trainees. In those studies we did review, the study quality was generally poor. Most of the programs had no guiding conceptual framework, minimal literature review, and outcomes were almost exclusively learner-reported.
MedicalResearch.com: What should readers take away from your report?
Response: Despite our sparse findings, the take-home message for us is not negative. This is an incredibly difficult topic to address, and increased awareness is the first step towards change. Readers interested in addressing mistreatment in their own institutions can take away a few messages: first, this is an important topic and new work is very much needed. Second, we provide some specific recommendations in our discussion section for creating and reporting on programs to decrease mistreatment.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: This is a topic that needs more research! Our results are, to some extent, a call to arms. Not enough is being done to address this problem, and I suspect we don’t even fully understand what the problem is. Specific next steps include developing a more nuanced understanding of what constitutes mistreatment, and the development of theory-based interventions to decrease the incidence.
MedicalResearch.com: Is there anything else you would like to add?
Response: This topic is personal to us, because the authors on this paper have been working on the problem in our home institution (Stanford) for several years. Dr. James Lau, our senior author, has created a very well received and enduring mistreatment curriculum for the surgery core clerkship, and the published report of our own program is also included in our results for this paper. We understand the challenges faced by educators trying to decrease mistreatment because we have faced the same challenges.
On such a difficult and subjective topic, high quality research is challenging to achieve. We are extremely happy that this review article is being published, and we hope that others will continue to work with us on improving medical culture and raising the bar for mistreatment research.
Mazer LM, Bereknyei Merrell S, Hasty BN, Stave C, Lau JN. Assessment of Programs Aimed to Decrease or Prevent Mistreatment of Medical Trainees. JAMA Network Open. 2018;1(3):e180870. doi:10.1001/jamanetworkopen.2018.0870
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