Mapping the scientific research on the negative aspects of the medical school learning environment.

Rodolfo F Damiano,Lisabeth F Dilalla,Andrey O Da Cruz,Oscarina Da Silva Ezequiel,José G De Oliveira,Sean Tackett,Giancarlo Lucchetti

doi:10.1590/1806-9282.64.11.1050

Abstract

We sought to understand the landscape of published articles regarding medical schools' learning environments (LE) worldwide, with an explicit focus on potentially negative aspects of the LE as an effort to identify areas specifically in need of remediation or intervention that could prevent future unprofessional behaviours, burnout, violence and mistreatment among students and physicians. A bibliometric analysis was conducted in six electronic databases (PubMed/Medline, Web of Science, Cochrane Library, SCOPUS, ERIC-ProQuest and PsycINFO) through December 31, 2016, including 12 themes: learning environment - general, hidden curriculum (negative), unethical behaviours, bullying/hazing, violence, sexual discrimination, homophobia, racism, social discrimination, minorities' discrimination, professional misconduct, and "other" negative aspects. Of 9,338 articles found, 710 met the inclusion criteria. The most common themes were general LE (233 articles), unprofessional behaviours (91 articles), and sexual discrimination (80 articles). Approximately 80% of articles were published in the 21st century. There is a clear increase in scientific articles on negative aspects of the medical school LE in high-quality journals, especially in the 21st century. However, more studies are needed to investigate negative LE aspects with greater attention paid to experimental, longitudinal, and cross-cultural study designs.

Highlights

Environment can be defined as “the surroundings or conditions in which a person, animal, or plant lives or operates”.1 This concept, derived from the biological sciences, has increasingly been the subject of study in medical sciences and educational research
In relation to the instruments used to measure the learning environments (LE), we found high use of the following tools: the Dundee Ready Education Environment Measure (DREEM),[2] the Medical Student Learning Environment Scale (MSLES),[22,23] and the most recent Johns Hopkins Learning Environment Scale (JHLES).[4]
We have identified ten main negative areas that might impact students’ perception of their LE: unprofessional behaviors;[17] sexual discrimination;[24] minorities discrimination;[25] violence;[26] hidden curriculum;[27] unethical behaviors;[28] racism;[28] homophobia;[30] bullying/ hazing;[31] and social discrimination.[32]

Summary

Introduction

Environment can be defined as “the surroundings or conditions in which a person, animal, or plant lives or operates”.1 This concept, derived from the biological sciences, has increasingly been the subject of study in medical sciences and educational research. Environment can be defined as “the surroundings or conditions in which a person, animal, or plant lives or operates”.1. This concept, derived from the biological sciences, has increasingly been the subject of study in medical sciences and educational research. The first study that focused on studying learning environments (LE) in higher education dates back to 1958.5 Concerning medical schools’ LEs, Hutchins (in 1961)[6] developed the first questionnaire and the first attempt to understand quantitatively how the environment might impact students’ attitudes, values, DATE OF SUBMISSION: 07-Aug-2018 DATE OF ACCEPTANCE: 27-Aug-2018 Corresponding Author: Rodolfo F. Dr Ovídio Pires de Campos, 875 – Cerqueira César – São Paulo, SP – Brasil – 05403-903

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