A pilot survey of patient-initiated assaults on medical students during clinical clerkship
ABSTRACT To assess the incidents of patient-initiated assault (PIA) against clinical clerks during the first six months of clinical clerkship. To characterise the assaults with respect to service, location, clerk gender, patient gender. To examine the students' perceptions of the reporting process for PIA.
A brief email survey was sent to all third year medical students after six months of clinical clerkship experience. Students were asked to describe assault experiences including: location, service, patient gender and injuries sustained.
Six students reported experiencing physical assault in the first six months of clerkship. Assaults occurred on psychiatry (4) and internal medicine (2) services. Two of the assaults took place during consultations in the emergency department. All students reported having pre-clerkship training in management of violent situations. No students were aware of PIA reporting protocols for their hospital.
Clinical clerks are at risk of PIA during their training. Students experiencing PIA feel that current levels of pre-clerkship training do not adequately inform them of the resources available after such an incident. These findings underline the need for PIA programs in the undergraduate curriculum including preclerkship training and clear, institution-wide reporting guidelines.
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ABSTRACT: Objectives: Psychiatry education in medical schools seems to be given little attention and has not been fully integrated into curriculum. In this study our purpose was to get feedback about all phases of psychiatry clerkship from medical students, who completed psychiatry clerkship. Methods: A 31 item questionnaire investigating the views of medical students about psychiatry clerkship and a sociodemographic survey were given to the medical students, who completed psychiatry clerkship and signed informed consent prior to study procedures. Results: A total of 208 students agreed and signed consent to participate in the study. The number of female and male students were 114 & 94, respectively and mean age was 22.7±1.02. Most of the students (89%) expected from the lecturers “to teach how to manage aggressive patients.” Seventy six percent of students specified the requirement of consultation liasion education because “psychiatric symptoms could be seen in general medical conditions.” Seventy percent of students reported that they wanted to watch and discuss standart patient video records. Fifty three percent of the students emphasized that “Psychiatry examination was only assessing knowledge, but not the skills.” Seventy eight percent of students reported that “they wished to follow up the patients along a resident’’ and 64% “with an attending.” Also, 54% of students supported to participate in a research project or seminar related to psychiatry (e.g. neuroimmunology, neuroanatomy, psychoendocrinology) in previous years. Conclusion: The efforts to increase interest and improve outcome and effectiveness in psychiatry clerkship education have become more important. This is the first study on this topic in our country. To improve outcome and effectiveness in psychiatry clerkship education, the educators should find the balance between the views of medical students and experienced faculty members about the topics to be taught during the rotation. Key words: psychiatry, psychiatry clerkship education, curriculum, clinical skills training09/2012; 2(3):103-108. DOI:10.5455/jmood.20120810045409
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ABSTRACT: Objective. The goal of this study was to examine the monthly incidence rates of abusive encounters for family physicians in Canada. Methods. A 7-page cross-sectional survey. Results. Of the entire study sample (N = 720), 29% of the physicians reported having experienced an abusive event in the last month by a patient or patient family member. Abusive incidents were classified as minor, major, or severe. Of the physician participants who reported having been abused, all reported having experienced a minor event, 26% a major, and 8% a severe event. Of the physicians who experienced an abusive event, 55% were not aware of any policies to protect them, 76% did not seek help, and 64% did not report the abusive event. Conclusion. Family physicians are subjected to significant amounts of abuse in their day-to-day practices. Few physicians are aware of workplace policies that could protect them, and fewer report abusive encounters. Physicians would benefit from increased awareness of institutional policies that can protect them against abusive patients and their families and from the development of a national policy.11/2010; 2010:387202. DOI:10.1155/2010/387202
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ABSTRACT: Harassment and discrimination include a wide range of behaviors that medical trainees perceive as being humiliating, hostile, or abusive. To understand the significance of such mistreatment and to explore potential preventive strategies, the authors conducted a systematic review and meta-analysis to examine the prevalence, risk factors, and sources of harassment and discrimination among medical trainees. In 2011, the authors identified relevant studies by searching MEDLINE and EMBASE, scanning reference lists of relevant studies, and contacting experts. They included studies that reported the prevalence, risk factors, and sources of harassment and discrimination among medical trainees. Two reviewers independently screened all articles and abstracted study and participant characteristics and study results. The authors assessed the methodological quality in individual studies using the Newcastle-Ottawa Scale. They also conducted a meta-analysis. The authors included 57 cross-sectional and 2 cohort studies in their review. The meta-analysis of 51 studies demonstrated that 59.4% of medical trainees had experienced at least one form of harassment or discrimination during their training (95% confidence interval [CI]: 52.0%-66.7%). Verbal harassment was the most commonly cited form of harassment (prevalence: 63.0%; 95% CI: 54.8%-71.2%). Consultants were the most commonly cited source of harassment and discrimination, followed by patients or patients' families (34.4% and 21.9%, respectively). This review demonstrates the surprisingly high prevalence of harassment and discrimination among medical trainees that has not declined over time. The authors recommend both drafting policies and promoting cultural change within academic institutions to prevent future abuse.Academic medicine: journal of the Association of American Medical Colleges 03/2014; DOI:10.1097/ACM.0000000000000200 · 3.47 Impact Factor