From Hope to Hardship: Understanding the Impact of Hierarchies and Violence in Medicine

Authors

Keywords:

Medical Students, Medical Education, Workplace Violence, Hierarchies, Health Personnel

Abstract

This article is an experience piece reflecting on my journey through medical school rotations, highlighting the pervasive nature of workplace violence (WPV) and its impact on students' motivation and mental health. I discuss the high incidence of mistreatment and its correlation with burnout, imposter syndrome, and decreased academic performance among trainees. I emphasize the importance of recognizing and addressing subtle forms of WPV, including microaggressions and systemic issues, and advocate for proactive measures such as education, training, and fostering cultural change within healthcare institutions. Through reflecting on my experiences and observations, I aim to inspire systemic change and empower individuals to contribute to a healthier, more empathetic medical culture.

Metrics

Metrics Loading ...

References

Occupational Health and Safety Administration. Workplace Violence. Available from: https://www.osha.gov/hospitals/workplace-violence. Cited May 1, 2024.

Hershkovitz MS, Turner N, Barling J, Arnold KA, Dupré KE, Inness M, et al. Predicting workplace aggression: a meta-analysis. J Appl Psychol. 2007;92(1):228-238.

Escribano RB, Beneit J, Luis Garcia J. Violence in the workplace: some critical issues looking at the health sector. Heliyon. 2019;5(3):e01283.

Hamui-Sutton L, Paz-Rodriguez F, Sánchez-Guzmán A, Vives-Varela T, Corona T. Violence and Clinical Learning Environments in Medical Residencies. Int J Environ Res Public Health. 2023;20(18):6754.

Markman JD, Soeprono TM, Combs HL, Cosgrove EM. Medical student mistreatment: understanding 'public humiliation'. Med Educ Online. 2019;24(1):1615367.

Scott KM, Caldwell PH, Barnes EH, Barrett J. "Teaching by humiliation" and mistreatment of medical students in clinical rotations: a pilot study. Med J Aust. 2015;203(4):185e.1-185e.6.

Vanstone M, Grierson L. Thinking about social power and hierarchy in medical education. Med Educ. 2022;56(1):91-97.

Salehi PP, Jacobs D, Suhail-Sindhu T, Judson BL, Azizzadeh B, Lee YH, et al. Consequences of Medical Hierarchy on Medical Students, Residents, and Medical Education in Otolaryngology. Otolaryngol Head Neck Surg. 2020;163(5):906-914.

Essex R, Kennedy J, Miller D, Jameson J. A scoping review exploring the impact and negotiation of hierarchy in healthcare organisations. Nurs Inq. 2023;30(4):e12571.

Hamrish Kumar Rajakumar, Gaman, M.-A., Puyana, J. C., & Bonilla-Escobar, F. J. (2024). Transforming Toxic Research Cultures: Protecting the Future of Medical Students and Early Career Researchers – Part I. International Journal of Medical Students, 12(2), 128–132. https://doi.org/10.5195/ijms.2024.2763

Yan, W., Bao, N., Zheng, S., Wang, H., Yue, D., & Chen, L. (2023). The impacts of patient mistreatment on healthcare workers' role behaviors: a study in Chinese Fangcang shelter hospitals. BMC nursing, 22(1), 444. https://doi.org/10.1186/s12912-023-01574-5

Legassie J, Zibrowski EM, Goldszmidt MA. Measuring resident well-being: impostorism and burnout syndrome in residency. J Gen Intern Med. 2008;23(7):1090-1094.

Rosenberg DA. Medical student abuse. An unnecessary and preventable cause of stress. JAMA. 1984;251(6):739-742.

Barbanti, P. C. M., Oliveira, S. R. L., de Medeiros, A. E., Bitencourt, M. R., Victorino, S. V. Z., Bitencourt, M. R., Alarcão, A. C. J., Egger, P. A., Pelloso, F. C., Borghesan, D. H. P., de Souza, M. P., Marques, V. D., Pelloso, S. M., & Carvalho, M. D. B. (2022). Prevalence and Impact of Academic Violence in Medical Education. International journal of environmental research and public health, 19(18), 11519. https://doi.org/10.3390/ijerph191811519

Timm A. 'It would not be tolerated in any other profession except medicine': survey reporting on undergraduates' exposure to bullying and harassment in their first placement year. BMJ Open. 2014;4(7):e005140.

Caruso, R., Toffanin, T., Folesani, F., Biancosino, B., Romagnolo, F., Riba, M. B., McFarland, D., Palagini, L., Belvederi Murri, M., Zerbinati, L., & Grassi, L. (2022). Violence Against Physicians in the Workplace: Trends, Causes, Consequences, and Strategies for Intervention. Current psychiatry reports, 24(12), 911–924. https://doi.org/10.1007/s11920-022-01398-1

National Institute for Occupational Safety and Health. (2006). Workplace violence prevention strategies and research needs : report from the conference Partnering in Workplace Violence Prevention: Translating Research to Practice, November 15-17, 2004, Baltimore, Maryland.

Arnetz J. E. (2022). The Joint Commission's New and Revised Workplace Violence Prevention Standards for Hospitals: A Major Step Forward Toward Improved Quality and Safety. Joint Commission journal on quality and patient safety, 48(4), 241–245. https://doi.org/10.1016/j.jcjq.2022.02.001

Jones, C. B., Sousane, Z., & Mossburg, S. (2023). Addressing workplace violence and creating a safer workplace. PSNet. Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services. https://psnet.ahrq.gov

Einarsen SH, Notelaers G. Measuring exposure to bullying at work: validity, factor structure and psychometric properties of the Negative Acts Questionnaire-Revised. Work Stress. 2009;23(1):24-44.

Taylor R. Nurses' perceptions of horizontal violence. Glob Qual Nurs Res. 2016;3:2333393616641002.

Yosep I, Mardhiyah A, Hendrawati H, Hendrawati S. Interventions for reducing negative impacts of workplace violence among health workers: a scoping review. J Multidiscip Healthc. 2023;16:1409-1421.

Downloads

Published

2024-11-19

How to Cite

Cors Cepeda, X. (2024). From Hope to Hardship: Understanding the Impact of Hierarchies and Violence in Medicine. International Journal of Medical Students. Retrieved from https://ijms.pitt.edu/IJMS/article/view/2679

Issue

Section

Experience

Categories