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Investigación en Educación Médica

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Investigación en Educación Médica
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2018, Number 26

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Inv Ed Med 2018; 7 (26)

Perception of mistreatment during medical residency in Mexico: evaluation and bioethical analysis

Derive S, Casas MML, Obrador VGT, Villa AR, Contreras D
Full text How to cite this article

Language: Spanish
References: 30
Page: 35-44
PDF size: 349.81 Kb.


Key words:

Mistreatment, Medical residency, Abuse, Depression.

ABSTRACT

Introduction: Multiple interpersonal interactions are one of the many challenges faced by medical residents. Mistreatment towards residents has been shown to interfere with their training. However, there are few data about this phenomenon in Mexico.
Objective: To evaluate the perception of different types of mistreatment among medical residents and to make a bioethical analysis of the results.
Method: An electronic, 107-question survey was sent to medical residents of the Mexico State to assess their perception about psychological, physical, academic mistreatment, and sexual abuse. Attempts were also made to identify the person responsible for the mistreatment and its consequences. Analyses included descriptive statistics of mistreatment and its types, as well as sociodemographic data of participants. Logistic regression was used to assess risk factors for mistreatment.
Results: A total of 143 responses were obtained (8.2% response rate), with 84% of the residents reported having suffered mistreatment. The most frequent type was psychological (humiliation 78%), followed by academic (50% staying on call as a punishment and denial of education in 40%), and physical abuse (16% were beaten, 35% were deprived of food, and 21% were not allowed to go to the bathroom while being on call, as punishment). Also, 21% were pressured to consume alcohol against their will. Psychological and physical mistreatment were more frequent in surgical than medical specialties. As a result of mistreatment, 89% of residents reported burnout, 71% depression, 78% anxiety, and 58% sub-optimal patient care. The main perpetrators of the mistreatment were senior residents and attending physicians.
Conclusions: Abuse during residency is very frequent, and affects the human rights and dignity of residents. It also reduces the learning capacity and efficiency of specialty training, in a country with a high demand for health care that requires optimisation of economic and human resources.


REFERENCES

  1. Baldwin D, Daugherty S, Eckenfels E. Student perception of mistreatment and harassment during medical school. A survey in ten United States schools. West J Med. 1991;155:140---5.

  2. Komarony M, Bindman A, Haben R, Sande M. Sexual harassment in medical training. N Engl J Med. 1993;328:322---6.

  3. McNamara R, Whitley T, Sanders A, Andrew L. The extent and effects of abuse and harassment on emergency medicine residents. Acad. Emerg. Med. 1995;4:293---301.

  4. Li S, Grant K, Cowan E. Resident experience of abuse and harassment in emergency medicine: ten years later. J Emerg Med. 2010;38:248---52.

  5. Fried J, Vermillion M, Parker N, Uijtdehaage S. Eradicating medical student mistreatment: a longitudinal study of one institution’s efforts. Acad Med. 2012;87:1191---8.

  6. Cook D, Walter S. Residents’ experiences of abuse, discrimination and sexual harassment during residency training. CMAJ. 1996;154:1657---65.

  7. Nagata-Kobayashi S, Maeno T, Yoshizu M, Shimbo T. Universal problems during residency: abuse and harassment. Medical Education. 2009;43:628---36.

  8. Mejía R, Diego A, Lasala F. Percepción de maltrato durante la capacitación de médicos residentes. Medicina. 2005;65:295---301.

  9. Bastias N, Fasce E, Ortiz L, Pérez C, Schaufele P. Bullying y acoso en la formación médica de posgrado. Rev. Educ. Cienc. Salud. 2011;8:45---51.

  10. Richardson-López Collada V. Y a nuestros residentes ¿quién los cuida? Bol. Med. Hosp. Infant. Mex. 2006;63. Editorial.

  11. Herrera-Silva J, Treviño-Moore A, Acosta-Corona C. Características de la violencia en residentes de dos instituciones formadoras de pediatras en el estado de Sonora. Bol Med Hosp Infant. Mex. 2006:18---30.

  12. Ortíz-León S, Jaimes-Medrano A, Tafoya-Ramos S, Mujíca- Amaya M, Olmedo-Canchola V, Carrasco-Rojas J. Experiencias de maltrato y hostigamiento en médicos residentes. Cir Cir. 2014;82:290---301.

  13. Carrillo-Esper R, Gómez-Hernández K. Bullying durante el pre y posgrado de la formación médica. Rev Invest Med Sur Mex. 2014;21:172---6.

  14. Chávez-Rivera A, Ramos-Lira L, Abreu-Hernández L. Una revisión sistemática del maltrato en el estudiante de medicina. Gac Med Mex. 2016;152:796---811.

  15. Cámara de Diputados Ley Federal de protección de datos personales en posesión de los particulares. México. 2010.

  16. Crutcher RA, Szafran O, Woloschuk W, Chatur F, Hansen C. Family medicine graduates’ perceptions of intimidation, harassment and discrimination during residency training. BMC Medical Education. 2011;11:88.

  17. Morales-Carmona F, Sánchez Bravo C. La supervisión como detonador de estrés en la práctica médica: Recomendaciones para su manejo. Perinatol Reprod Hum. 2010;24:187---93.

  18. Fnais N, Soobiah C, Chen M, Lillie E, Perrier L, Tashkhandi M, et al. Harassment and discrimination in medical training: a systematic review and meta- analysis. Acad Med. 2014;89:817---27.

  19. Silver H, Glicken A. Medical student abuse. Incidence, severity, and significance. JAMA. 1990;263:527---32.

  20. Pappas P, Gouva M, Gourgoulianis K, Hatzoglou C, Kotrotsiou E. Psychological profile of Greek doctors: Differences among five specialties. Psychol Health Med. 2016;21:439---47.

  21. Secretaría de Salud, Estados Unidos Mexicanos. (04 de 01 de 2013). Norma Oficial Mexicana NOM-001- SSA3-2012. México, Distrito Federal, México: Art. 7, Fracción 7.1.1.

  22. Comisión Nacional de Arbitraje Médico, Carta de los Derechos Generales de los Médicos. México. 2001.

  23. Abreu-Hernández L, Cid-García A, Herrera-Correa G, Lara-Vélez J, Laviada-Delgadillo R, Rodríguez-Arroyo C, et al. Perfil por competencias del médico general mexicano 2008. México: Asociación Mexicana de Facultades y Escuelas de Medicina, A.C.; 2008.

  24. Consejo, Chapela C, Viesca Treviño C. Ética y poder: formación de residentes e internos. Rev Med IMSS. 2005;43:1---3. Editorial.

  25. Sheehan K. E-mail Survey response rates: A Review. JCMC. 2001;6.

  26. Cortés Barré M. La letra con sangre entra: el maltrato en la formación médica. Universitas Medica. 2010;51:43---8.

  27. Gordon F, Hazlett C, Cate O, Mann K, Kilminster S, Prince K, et al. Strategic Planning in medical education: enhancing the learning environment for students in clinical settings. Med Educ. 2000;34:841---50.

  28. Brooks N, Moriarty A. Development of a practice learning team in the clinical setting. Nursing Standard. 2006;20:41---4.

  29. West R. Teaching in the clinical setting. Psychiatry. 2007;70:218---20.

  30. CONBIOETICA. Guía nacional para la integración y el funcionamiento de los Comités Hospitalarios de Bioética. Cuarta edición 2013. [consultado 15 Jul 2015]. Disponible: http://www.conbioetica- mexico.salud.gob.mx/interior/ registrocomites/ Guias.html.




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Inv Ed Med. 2018;7