Patricia Costa Mincoff Barbanti

Situations of mistreatment in the academic environment are prevalent worldwide, but research in this area is scarce in middle-low-income countries. This study aimed to estimate the prevalence of mistreatment inflicted against Brazilian medical students. In addition, characterize these situations and analyze their consequences. Cross-sectional study conducted with 831 medical students from public and private institutions. Absolute and relative frequencies of the analyzed variables and possible associations were determined through univariate and multivariate logistic regression. Chi-square test of association with second-order Rao-Scott adjustment was also used. The response rate was 56%. Public institution pointed to a higher prevalence of mistreatment when compared to private (59% versus 43%). Female students were the most affected. Verbal and psychological aggression was more prevalent. The aggressor usually was a faculty member. Mistreatment incidence increased over the years of training, with higher rates in the internship. About 94% of the students felt affected in anyway, with 77% feeling diminished and depressed. More than 50% reported impaired academic performance. Almost 30% sought help from experts. The reporting rate was extremely low. Adequate identification of the situations by the victims, safe reporting mechanisms and, an educational system capable of maintaining an appropriate learning environment are essential to break this destructive cycle.

Introduction: The occurrence of abuse, harassment and mistreatment of medical students is a widespread phenomenon and not a problem limited to certain countries or particular schools. Such behavior during medical training creates hostile learning environments, induces stress, depressive symptoms, may impair performance and patient care. Objective: To analyze the methodology used in recent studies to describe the consequences of mistreatment on medical student’s life and academic performance. Method: A brief review of the literature indexed in 6 international databases was carried out (PubMed, Scopus, Web of Science, SciELO, PsycINFO and Cochrane Library). The descriptors were categorized into two groups, one containing different types of violence and the other contemplating the studied population. Results: A total of 20 articles were selected for this study and all of them based their research methodology on the use of questionnaires, scales and/or interviews. The strengths and weaknesses of these methodologies were discussed, and the use of simulation was suggested as a new methodological alternative. Conclusion: This review reinforces that mistreatment of medical students has remained frequent over time and it is closely related to the students’ mental health and performance impairment. The authors recommend a new methodological approach to collect data related to the effects arising from a hostile learning environment.