Introduction
Incivility in medical education is a pervasive issue that can significantly impact the learning environment and the well-being of students, residents, and faculty. A recent scoping review titled Incivility in medical education: a scoping review provides a comprehensive overview of this problem, highlighting the types of incivility, the perpetrators, the victims, and the settings where these behaviors occur. This blog aims to summarize the key findings from the review and provide actionable insights for practitioners to improve their skills and create a more positive educational environment.
Types of Incivility
The review categorizes incivility into several types:
- Verbal Abuse: Rude or demeaning behavior, public belittling, and aggressive questioning.
- Sexual Harassment: Inappropriate flirting, sexual favors for grades, and unwanted sexual advances.
- Gender and Racial Discrimination: Denial of opportunities, lower evaluations, and racial harassment.
- Physical Abuse: Less frequently reported but includes physical intimidation and assault.
- Power-Based Incivility: Abuses of power asymmetries, exclusion from team functions, and neglect.
Perpetrators and Victims
The review identifies various perpetrators of incivility:
- Residents: Most frequent perpetrators towards medical students.
- Faculty: Common perpetrators of arrogance, cultural insensitivity, and power abuse.
- Nurses and Patients: Also identified as significant sources of incivility.
Victims of incivility span across all levels of medical education:
- Medical Students: High rates of verbal and sexual harassment, particularly among female students.
- Residents: High rates of bullying and shaming, with specific demographic groups at increased risk.
- Faculty: Gender discrimination and sexual harassment, particularly affecting female and minority faculty members.
Settings and Impact
Incivility is reported across various settings:
- Specialties: Higher rates in general surgery and obstetrics and gynecology.
- Clinical Settings: Operating rooms and emergency rooms are common locations.
- Educational Settings: Clerkships and pre-clerkship education.
The impact of incivility is profound:
- On Individuals: Burnout, depression, changes in career choices, and diminished self-esteem.
- On Institutions: Compromised patient care, reduced productivity, and high turnover rates.
Actionable Insights for Practitioners
Based on the findings of the review, here are some actionable steps practitioners can take:
- Promote Reporting: Encourage a culture where reporting incivility is safe and supported.
- Implement Training: Conduct workshops on recognizing and addressing incivility, including role-playing scenarios.
- Foster Inclusion: Create an inclusive environment where all team members feel valued and respected.
- Establish Policies: Develop clear, zero-tolerance policies for incivility and ensure they are well-communicated and enforced.
Conclusion
Incivility in medical education is a significant issue that requires a multi-faceted approach to address effectively. By understanding the types, perpetrators, victims, and settings of incivility, practitioners can take informed actions to create a more positive and supportive educational environment.
To read the original research paper, please follow this link: Incivility in medical education: a scoping review.
