Underlying mechanisms of mistreatment in the surgical learning environment: A thematic analysis of medical student perceptions

Abstract

BackgroundMedical students experience more psychological distress than the general population. One contributing factor is mistreatment. This study aims to understand the mechanisms of mistreatment as perceived by medical students. MethodsStudents completed anonymous surveys during the first and last didactic session of their surgery clerkship in which they defined and gave examples of mistreatment. Team-based thematic analysis was performed on responses. ResultsBetween January 2014 and June 2016, 240 students participated in the surgery clerkship. Eighty-nine percent of students completed a survey. Themes observed included (1) Obstruction of Students' Learning, (2) Exploitation of Student Vulnerability, (3) Exclusion from the Medical Team, and (4) Contextual Amplifiers of Mistreatment Severity. ConclusionThe themes observed in this study improve our understanding of the students' perspective on mistreatment as it relates to their role in the clinical learning context, which can serve as a starting point for interventions that ultimately improve students' experiences in the clinical setting.