On the culture of student abuse in medical school

被引:151
作者
Kassebaum, DG
Cutler, ER
机构
[1] Assoc Amer Med Coll, Div Med Sch Stand & Assessment, Washington, DC 20037 USA
[2] Assoc Amer Med Coll, Liaison Comm Med Educ, Washington, DC 20037 USA
关键词
D O I
10.1097/00001888-199811000-00011
中图分类号
G40 [教育学];
学科分类号
040101 ; 120403 ;
摘要
The abuse of students is ingrained in medical education, and has shown little amelioration despite numerous publications and righteous declarations by the academic community over the past decade. The culture of abuse conflicts with the renewed commitments of medical educators and practice professionals to imbue students with a higher degree of professionalism and cultural sensitivity. The authors describe the profiles of student abuse, drawn from recent national surveys of medical students using the AAMC Medical School Graduation Questionnaire, and focus on the most common forms of reported mistreatment-public belittlement and humiliation-that appear to be misguided efforts to reinforce learning. Along with others, the authors believe that the use of aversive methods to make students learn. and behave is likely to foster insensitive and punitive behaviors that are passed down from teacher to learner, a "transgenerational legacy" that leads to future mistreatment of others by those who themselves have been mistreated. The undesirable result is compounded when these behaviors are adopted and directed toward patients and colleagues. The authors advocate more concerted action to curtail the abuse of medical students, citing current and proposed accreditation standards that will be employed more stringently by the LCME, and propose a series of more assertive actions that schools should take. The authors stress that the attitudes, behaviors, and values that students acquire in medical school are as much the products of their socialization as the outcomes of curricular design and pedagogy, and implore medical educators to tidy up the environment for learning.
引用
收藏
页码:1149 / 1158
页数:10
相关论文
共 27 条
[1]  
*AAMC, 1992, 9238 AAMC
[2]  
*AMA HOUS DEL POL, 1997, TEACH LEARN REL MED
[3]  
BALDWIN DWC, 1991, WESTERN J MED, V155, P140
[4]  
Becker H.S., 1961, BOYS WHITE STUDENT C
[5]  
BOUGEOIS JA, 1993, MED EDUC, V27, P363
[6]   ETHICS IN A SHORT WHITE COAT - THE ETHICAL DILEMMAS THAT MEDICAL-STUDENTS CONFRONT [J].
CHRISTAKIS, DA ;
FEUDTNER, C .
ACADEMIC MEDICINE, 1993, 68 (04) :249-254
[7]   Learning, satisfaction, and mistreatment during medical internship - A national survey of working conditions [J].
Daugherty, SR ;
Baldwin, DC ;
Rowley, BD .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1998, 279 (15) :1194-1199
[8]   DO CLINICAL CLERKS SUFFER ETHICAL EROSION - STUDENTS PERCEPTIONS OF THEIR ETHICAL ENVIRONMENT AND PERSONAL DEVELOPMENT [J].
FEUDTNER, C ;
CHRISTAKIS, DA ;
CHRISTAKIS, NA .
ACADEMIC MEDICINE, 1994, 69 (08) :670-679
[9]   THE HIDDEN CURRICULUM, ETHICS TEACHING, AND THE STRUCTURE OF MEDICAL-EDUCATION [J].
HAFFERTY, FW ;
FRANKS, R .
ACADEMIC MEDICINE, 1994, 69 (11) :861-871
[10]   Beyond curriculum reform: Confronting medicine's hidden curriculum [J].
Hafferty, FW .
ACADEMIC MEDICINE, 1998, 73 (04) :403-407