Mistreatment of medical students in Paraguay in 2022: a multicenter survey
DOI:
https://doi.org/10.52379/mcs.v7i3.305Keywords:
medical students, surveys and questionnaires, sexual harassment, whistleblowingAbstract
Introduction: medical students are prone to mistreatment from their colleagues, administrative staff, and patients. Objective: to determine the characteristics of the mistreatment of medical students in Paraguay in 2022. Methodology: an observational, cross-sectional design was applied. Medical students of both sexes who agreed to participate in the online survey were included. Sampling was for convenience. Demographic variables were measured. The perception of abuse was evaluated according to four components (psychological, physical, academic, and sexual) using the previously validated questionnaire by Munayco-Guillén F et al. The study was approved by the Ethics Committee of the Universidad Privada del Este, Paraguay. Results: the questionnaire was answered by 214 students, 146 being women (mean age 24 ± 3 years) and 68 men (mean age 25 ± 5 years). The majority reside in Asunción (29.4%) and attend private universities (92%). The mean ± SD of psychological abuse was 1.89 ± 1.02, physical abuse was 1.64 ± 0.89, academic abuse was 2.01 ± 1.11, and sexual abuse was 1.4 ± 0. 83. Applying cut-off points at the 60th and 70th percentiles, the abuse was mild in 126 students (58.9%), moderate in 24 (11.2%), and severe in 64 (29.9%). The main reason for not reporting it was fear of being singled out by others or receiving reprisals (17.3%). Discussion: mild abuse was detected in 58.9%, moderate in 11.2%, and severe in 29.9% of medical students. It is necessary to apply measures to prevent and contain abuse.
Downloads
References
Sierra Córdova A, Zárate Cáceres J, Mejia C. Maltrato asociado al acoso laboral a internos de Medicina en hospitales peruanos. Educ Med Super [Internet]. 2019;33(4):37–50. Available from: http://scielo.sld.cu/pdf/ems/v33n4/1561-2902-ems-33-04-e1720.pdf
Munayco-Guillén F, Cámara-Reyes A, Muñoz-Tafur LJ, Arroyo-Hernández H, Mejia CR, Lem-Arce F, et al. Características del maltrato hacia estudiantes de medicina de una universidad pública del Perú. Rev Peru Med Exp Salud Pública. 2016;33(1):58–66. https://doi.org/10.17843/rpmesp.2016.331.2008
Reyes Arellano WA, Ramírez Grycuk MT, Ponce de León Castañeda ME, García García JJ. Maltrato en el pregrado de la Facultad de Medicina de la UNAM. Inv Ed Med. 2019;30(2):18–29. https://doi.org/10.22201/facmed.20075057e.2019.30.1773
Ehie O, Muse I, Hill LM, Bastien A. Professionalism: microaggression in the healthcare setting. Curr Opin Anaesthesiol. 2021;34(2):131–6. https://doi.org/10.1097/ACO.0000000000000966
Mavis B, Sousa A, Lipscomb W, Rappley MD. Learning about medical student mistreatment from responses to the medical school graduation questionnaire. Acad Med. 2014;89(5):705–11. https://doi.org/10.1097/ACM.0000000000000199
Barbanti PCM, Oliveira SRL de, Pelloso SM, Carvalho MD de B. Effects of mistreatment in medical schools: how to evaluate? A brief review. Rev Bras Educ Med. 2021;45(3):e0138. https://doi.org/10.1590/1981-5271v45.3-20210054.ing
Barrios I, Miltos V, Piris A, Piris G, Ramírez C, Rodríguez J, et al. Tamizaje de salud mental mediante el test M.I.N.I. en estudiantes del ciclo básico de Medicina de Universidad Nacional de Asunción. An Fac Cienc Méd. 2015;48(01):59–66. https://doi.org/10.18004/anales/2015.048(01)59-068
Barrios I, Piris A, Torales J, Viola L. Autoestima en estudiantes de medicina de la Universidad Nacional de Asunción, Paraguay. An Fac Cienc Méd. 2016;49(02):27–32. https://doi.org/10.18004/anales/2016.049(02)27-032
Torales J, Kadhum M, Zárate G, Barrios I, González I, Farrell SM, et al. Wellbeing and mental health among medical students in Paraguay. Int Rev Psychiatry. 2019;31(7–8):598–602. https://doi.org/10.1080/09540261.2019.1667172
Randolph MN, Erb EC, Garg PS, Thompson R, Cohen-Osher M. Training medical students as peer-facilitators to identify medical student mistreatment in the clerkship year. MedEdPORTAL. 2021;17:11185. https://doi.org/10.15766/mep_2374-8265.11185
Lind KT, Osborne CM, Badesch B, Blood A, Lowenstein SR. Ending student mistreatment: early successes and continuing challenges. Med Educ Online. 2020;25(1):1690846. https://doi.org/10.1080/10872981.2019.1690846
Mejia CR, Quiñones-Laveriano DM, Chacón JI, Aguirre-Valenzuela EA, Heredia-Torres PL, Miñan-Tapia A. Factores socioeducativos asociados a la percepción de maltrato en estudiantes de medicina peruanos. Educ Med Super [Internet]. 2018;32(1):74–84. Available from: http://scielo.sld.cu/scielo.php?script=sci_arttext&%0Apid=S0864-21412018000100008
Peres MFT, Babler F, Arakaki JNL, Quaresma IY do V, Barreto ADA de L, Silva ATC, et al. Mistreatment in an academic setting and medical students’ perceptions about their course in São Paulo, Brazil: A cross-sectional study. Sao Paulo Med J. 2016;134(2):130–7. https://doi.org/10.1590/1516-3180.2015.01332210
Bastías-Vega N, Pérez-Villalobos C, Alvarado-Figueroa D, Schilling-Norman M-J, Espinoza-Riffo M, Parra-Ponce P, et al. Maltrato en el pregrado de la carrera de Medicina: percepción de los estudiantes. Rev Med Chil. 2021;149(4):617–25. https://doi.org/10.4067/s0034-98872021000400617
Lall MD, Bilimoria KY, Lu DW, Zhan T, Barton MA, Hu YY, et al. Prevalence of discrimination, abuse, and harassment in emergency medicine residency training in the US. JAMA Netw Open. 2021;4(8):e2121706. https://doi.org/10.1001/jamanetworkopen.2021.21706
Oku AO, Owoaje ET, Oku OO, Monjok E. Mistreatment among undergraduate medical trainees: A case study of a Nigerian medical school. Niger J Clin Pr. 2014;17(6):678–82. https://doi.org/10.4103/1119-3077.144377
De la Cerda-Vargas M, Stienen M, Campero A, Pérez-Castell A, Soriano-Sánchez J, Nettel-Rueda B, et al. Burnout, discrimination, abuse, and mistreatment in latin america neurosurgical training during the coronavirus disease 2019 pandemic. World Neurosurg. 2021;S1878-8750(21)01699-5. https://doi.org/10.1016/j.wneu.2021.10.188
Bedoya Jojoa CM. Covid-19: La pandemia del maltrato contra el personal de la salud en tiempos de pandemia. Interdiscip J Epidemiol Public Heal. 2020;3(1):e6276. https://doi.org/10.18041/2665-427x/ijeph.1.6276
Owoaje ET, Uchendu OC, Ige OK. Experiences of mistreatment among medical students in a university in south west Nigeria. Niger J Clin Pr. 2012;15(2):214–9. https://doi.org/10.4103/1119-3077.97321
Moreno-Tetlacuilo LMÁ, Quezada-Yamamoto H, Guevara-Ruiseñor ES, Ibarra-Araujo N, Martínez-Gatica L, Pedraza-Moreno R. Las relaciones de género y el maltrato en las escuelas de medicina: una agenda pendiente en México y el mundo. Gac Med Mex. 2016;152(6):812–8. Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=69172
Siller H, Tauber G, Komlenac N, Hochleitner M. Gender differences and similarities in medical students’ experiences of mistreatment by various groups of perpetrators. BMC Med Educ. 2017;17(1):134. https://doi.org/10.1186/s12909-017-0974-4
Pradhan A, Buery-Joyner SD, Page-Ramsey S, Bliss S, Craig LTB, Everett E, et al. To the point: undergraduate medical education learner mistreatment issues on the learning environment in the United States. Am J Obs Gynecol. 2019;221(5):377–82. https://doi.org/10.1016/j.ajog.2019.04.021
Leisy HB, Ahmad M. Altering workplace attitudes for resident education (A.W.A.R.E.): discovering solutions for medical resident bullying through literature review. BMC Med Educ. 2016;16(1):127. https://doi.org/10.1186/s12909-016-0639-8
Slavin SJ, Chibnall JT. Mistreatment of medical students in the third year may not be the problem. Med Teach. 2017;39(8):891–3. https://doi.org/10.1080/0142159X.2016.1270438
Gan R, Snell L. When the learning environment is suboptimal: Exploring medical students’ perceptions of “mistreatment.” Acad Med. 2014;89(4):608–17. https://doi.org/10.1097/ACM.0000000000000172
Cheng MY, Neves SL, Rainwater J, Wang JZ, Davari P, Maverakis E, et al. Exploration of mistreatment and Burnout among resident physicians: a cross-specialty observational study. Med Sci Educ. 2020;30(1):315–21. https://doi.org/10.1007/s40670-019-00905-z
Cook AF, Arora VM, Rasinski KA, Curlin FA, Yoon JD. The prevalence of medical student mistreatment and its association with burnout. Acad Med. 2014;89(5):749–54. https://doi.org/10.1097/ACM.0000000000000204
Kulaylat AN, Qin D, Sun SX, Hollenbeak CS, Schubart JR, Aboud AJ, et al. Perceptions of mistreatment among trainees vary at different stages of clinical training. BMC Med Educ. 2017;17(1):14. https://doi.org/10.1186/s12909-016-0853-4
Hammoud MM, Appelbaum NP, Wallach PM, Burrows HL, Kochhar K, Hemphill RR, et al. Incidence of resident mistreatment in the learning environment across three institutions. Med Teach. 2021;43(3):334–40. https://doi.org/10.1080/0142159X.2020.1845306
Bell A, Cavanagh A, Connelly CE, Walsh A, Vanstone M. Why do few medical students report their experiences of mistreatment to administration? Med Educ. 2021;55(4):462–70. https://doi.org/10.1111/medu.14395
Griffith M, Clery MJ, Humbert B, Joyce JM, Perry M, Hemphill RR, et al. Exploring action items to address resident mistreatment through an educational workshop. West J Emerg Med. 2019;21(1):42–6. https://doi.org/10.5811/westjem.2019.9.44253
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Raúl Emilio Real-Delor, María Lucía Acosta Torreani , Elbert Yvan Aguilar Vergara , León Feliciano Benítez Delasgracias , Francisco Javier Benítez González , Luis Alberto Bordón Lezcano , Leticia Delgado Caballero , Iara Mariana Encina Villagra , María Mercedes Escobeiro de la Cruz , Rosana Mabel Maidana Barboza , Cristhian Hernán Quintana Vargas , Bettina Elizabeth Ramírez Fernández , Romina Antonieta Vázquez Vega
This work is licensed under a Creative Commons Attribution 4.0 International License.