..., and mistreatment by patients and fellow staff can all contribute to stress and distress during training that can push even well-adapted people to their limits. 1 Clinical environments vary widely in the degree of psychological and social support available to residents and fellows, and the long work hours often...

... programs. Instead, ensure that relevant resources are made readily available for reference. These include protocols on learner mistreatment, physician wellness, social media, and infection control. Program directors have identified social orientation—a concept in which trainees and staff are brought...

... , X @DO2Doc 2024 The learning risks inherent to clinical graduate medical education (GME) are great—even without extraneous challenges ( Figure 1 ). 1 - 5 Despite this, the clinical learning environment (CLE) has often been characterized by power distance, shame, humiliation, mistreatment...

... in wealth and power persisting since European contact. 9 Since Europeans arrived on this continent, Native people have been relegated to second class citizens on their own land. The history of Native Americans is one of constant mistreatment, displacement, and loss of autonomy. As Native populations...

..., Appelbaum N, Santern S, Vota S. Surveying the clinical learning environment in terms of wellness, burnout, psychological safety, and mistreatment in a neurology residency program at an academic medical centre...

... slights and insults on the target person or group.” 1 Often, microaggressions are expressions of implicit bias 1 against marginalized groups, including minoritized racial, sexual orientation, and religious groups, as well as women and people with disabilities. 2 Microaggressions are associated...

...Taj Mustapha, MD; Yedam Ho, MA; John S. Andrews, MD; Michael J. Cullen, PhD ABSTRACT Background Mistreatment of trainees, including discrimination and harassment, is a problem in graduate medical education. Current tools to assess the prevalence of mistreatment often are not administered...

... in a romantic relationship with a supervising faculty member, the relevance of the second step (understanding the impact of the rumor) is clear, as the power differential between the resident and the faculty member can lead to learner mistreatment and sexual harassment, which can create liability...

..., the trust required between patient and clinician, significant quality-of-life consequences of many decisions, and duty of physicians to place their patient's welfare at or above their own. Those in health care must also be continuously concerned with issues of honesty, integrity, ethics, and mistreatment...

... that their CLE was usually or always effective in managing reports of unprofessional behavior. In the group discussions, the CLER teams presented the residents and fellows with a scenario describing an attending physician's mistreatment of a resident colleague that continued to persist despite being reported...

.... Sustainable systems-based solutions also ensure that, early in their GME experience, residents and fellows are able to describe populations who, from the CLE's perspective, are at risk—and understand how these patient populations may receive disparate health care as a result of unintended, unrecognized bias...

... experiences also can have adverse effects on the professional trajectory of trainees, such as mistreatment from negative role models that puts trainees at risk for burnout. 7 Researchers have started to examine whether, and to what extent, personal exposure to role models influences the specialty choices...

... actually resemble those depicted in Full Metal Jacket , thanks to high rates of mistreatment, excessive competition, rigid hierarchies, and low levels of psychological safety. Insert into these environments medical learners grappling with vulnerability, fear of the unknown, self-doubt, and nagging...

... with these initiatives should be the complete elimination of behaviors that intentionally and unnecessarily exacerbate the baseline risks of learning medicine, which include mistreatment, humiliation, harsh pimping, uncivil behavior, shaming, exaggerated power differentials, and intergenerational derogation. We...

..., Marder WD. The changing environment of resident physicians . Health Aff (Millwood) . 1988 ; 7 ( suppl 2 ): 121 – 133 . 8 Daugherty SR, Baldwin DC Jr, Rowley BD. Learning, satisfaction, and mistreatment during medical internship: a national survey of working conditions...

... residents and fellows would follow to resolve perceived mistreatment if seeking assistance outside of the mechanisms offered by GME. While all CLEs have mechanisms to address disruptive and disrespectful behaviors, the findings suggest that existing mechanisms are not always effective. Even...

... of attributes. The CLER visits focused mainly on those involving honesty, integrity, and mistreatment. During each visit, the CLER team asked executive leaders whether or not there had been any GME-related incidents involving professionalism or integrity over the past two years. Across CLEs, 66.4...

.... Of the nearly 400 participants, 93% had experienced “disruptive behavior” during internship, including condescending behavior, berating, exclusion from decision-making, inappropriate jokes, abusive language, and gender bias. Even more concerning is the fact that 54% of the interns reported experiencing...

... (pp. 342). In the “Comments” category, Walsh recommends including discussions of costs and returns in reports on educational innovations (pp. 343), Schenning and Tseng comment on resident mistreatment and the efforts of the ACGME's Council of Review Committee Residents (pp. 344), and Yunyongying...

..., multispecialty surveys in 1989, 1999, and 2009. Each of these surveys has included a broad range of data concerning resident work and sleep hours, as well as data on learning, outside activities, stress, supervision, personal health, behavioral change, interprofessional conflict, impairment, and mistreatment...