Teaching by humiliation rife

19 Aug 2015

Two-thirds of medical students have experienced “teaching by humiliation” during clinical rotations,  new research shows.

The anonymous pilot survey of 146 students at the University of Sydney and the University of Melbourne found that 74% had been humiliated during their clinical rotations and 83% had witnessed it.

Humiliating and intimidating behaviour experienced by the students was more subtle than overt and included teachers being nasty, rude or hostile, said the researchers led by Dr Karen Scott, a senior lecturer at the University of Sydney.

Student responses to these practices ranged from disgust and regret about entering the medical profession to endorsement of teachers’ public exposure of a student’s poor knowledge, reported the authors in this week’s MJA. 

But up to half the students in the survey who had experienced or witnessed teaching by humiliation considered it to be “useful to learning” and “the natural socialisation of a good doctor”.

The survey showed that it wasn’t just medical or surgical teachers being rude to students. The specific professional group most frequently named was nursing and midwifery, reported by 59% of University of Melbourne students and 35% of University of Sydney students.

“When thinking about abuse as a cultural matter, our attention must be directed toward the culture of hospitals and all health care professionals, not just medicine or medical education,” the researchers wrote.

“The profession and the discipline of medical education would benefit from research to understand the complexity of factors that allows the cultural practices to be perpetuated and to identify ways to shift the culture,” they concluded.

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