Medical Student Response to Mistreatment by Patients

Abstract

Purpose: Medical student mistreatment is a pervasive problem in medical education. Recent studies have shown that patients and their families are responsible for a significant portion of reported mistreatment of medical students. This work has not translated into curriculum development in medical schools, and physicians and students express uncertainty with how to address instances of mistreatment by patients. Mistreatment has been shown to negatively impact medical students, particularly female medical students and medical students of color. Grounded in Structuration Theory, the goal of this review is to identify strategies medical students might use to respond to instances of mistreatment by patients to provide recommendations for how students might influence their learning environments. Method: In March 2018, a review of health professions literature yielded 21 articles describing strategies for provider response to instances of mistreatment by patients. Results: Literature on the topic recommend assertive techniques for discussing instances of mistreatment with the patient and informing the patient that discriminatory behavior is not appropriate in healthcare settings. Recommendations for response to sexual harassment, prejudiced refusals of care, and racist comments by patients are slightly different, with less clear suggestions for addressing racist comments. Conclusions: These findings suggest that there are tools medical students might use to address mistreatment by patients, but various types of mistreatment may require different strategies for responding. Future research is needed to determine which strategies are most effective at reducing mistreatment by patients or preventing negative impact on medical students.