More Than Aligning Perception: Impact of an Educational Intervention on Medical Student Mistreatment Reporting

Background: Despite decades of reporting, rates of medical student mistreatment on the surgical clerkship remains a national issue. To understand whether misaligned perceptions about what constitutes mistreatment were leading to the high rates of reported mistreatment at our institution, we implemented an intervention designed to educate students about the unique challenges of the surgical environment and to build consensus around the definition of mistreatment.

Study design: Medical students were recruited from the surgery clerkship to participate in a video vignette-based curriculum accompanied by a facilitated discussion. Participants completed a survey before and after the educational intervention to assess their understanding of mistreatment and their perceptions of the surgical learning environment. At the end of each clerkship block students who participated in the intervention, as well as students who did not participate, were asked to complete a questionnaire about their experiences during the clerkship.

Results: During 6 clerkship blocks, 53 students participated in the intervention (51% of the third-year student cohort). Students who participated in the intervention were more likely to report experiencing mistreatment or witnessing mistreatment during the clerkship. Students who participated in the intervention also reported experiencing neglect more frequently than students who did not participate.

Conclusions: We found that using an educational intervention designed to align perceptions of what constitutes mistreatment in the surgical learning environment did not decrease rates of mistreatment reporting on the surgical clerkship at our institution. Students who participated in the intervention reported increased confidence in their ability to define and recognize mistreatment after the intervention, as well as increased comfort reporting mistreatment and turning to faculty with concerns about mistreatment.