TY - JOUR
T1 - Lived Experiences of Mistreatment in a General Surgery Residency
AU - Dyurich, Adriana
AU - Prasad, Veena
AU - Mueller, Deborah L
AU - Hutcherson, Lisa
AU - Kempenich, Jason W.
AU - Dent, Daniel
AU - Botros-Brey, Sylvia
N1 - Publisher Copyright:
© 2022 Association of Program Directors in Surgery
PY - 2023/3
Y1 - 2023/3
N2 - OBJECTIVE: Explore the lived experiences of General Surgery residents to identify how they perceive, define mistreatment, and which factors can contribute to or mitigate mistreatment within the Clinical Learning Environment. DESIGN: This is a phenomenological study conducted during 2019-2020 using Giorgi's psychological descriptive phenomenology methodology. Researcher bias, trustworthiness, and triangulation were addressed using bracketing, check-ins with program leadership, comparisons to resident survey, and team consensus based on Consensual Qualitative Research. SETTING: General Surgery Residency program at Long School of Medicine, UT Health San Antonio, Texas. PARTICIPANTS: All residents in the general surgery program were invited to participate (n= 66, 43% female and 63% non-Hispanic). Specific demographic and identifying data for each participant was not collected. Approximately 50 (76% of program) residents from General Surgery participated. RESULTS: We were able to identify four themes that helped to delineate the lived experience of residents including program cultural factors, resident internal processing, and perceived effects of mistreatment by the residents. The resulting psychological structure and conceptual framework help clarify the interrelations between the themes and the Clinical Learning Environment. The scenarios discussed were adapted and depersonalized to use as prompts for the Forum Theater intervention. This project set out to explore resident's lived experiences and allow the data to reveal the main outcomes. The data was coded and analyzed following strict guidelines from descriptive psychological phenomenology and Consensual Qualitative Research with the aim of informing a later experiential intervention based on Forum Theater. CONCLUSIONS: The lived experience of general surgery residents helped identify cultural factors and behaviors that contribute to and/or mitigate mistreatment providing information to plan interventions at the resident and faculty level. Mitigating or stopping mistreatment can improve the Clinical Learning Environment and hence, the quality of training.
AB - OBJECTIVE: Explore the lived experiences of General Surgery residents to identify how they perceive, define mistreatment, and which factors can contribute to or mitigate mistreatment within the Clinical Learning Environment. DESIGN: This is a phenomenological study conducted during 2019-2020 using Giorgi's psychological descriptive phenomenology methodology. Researcher bias, trustworthiness, and triangulation were addressed using bracketing, check-ins with program leadership, comparisons to resident survey, and team consensus based on Consensual Qualitative Research. SETTING: General Surgery Residency program at Long School of Medicine, UT Health San Antonio, Texas. PARTICIPANTS: All residents in the general surgery program were invited to participate (n= 66, 43% female and 63% non-Hispanic). Specific demographic and identifying data for each participant was not collected. Approximately 50 (76% of program) residents from General Surgery participated. RESULTS: We were able to identify four themes that helped to delineate the lived experience of residents including program cultural factors, resident internal processing, and perceived effects of mistreatment by the residents. The resulting psychological structure and conceptual framework help clarify the interrelations between the themes and the Clinical Learning Environment. The scenarios discussed were adapted and depersonalized to use as prompts for the Forum Theater intervention. This project set out to explore resident's lived experiences and allow the data to reveal the main outcomes. The data was coded and analyzed following strict guidelines from descriptive psychological phenomenology and Consensual Qualitative Research with the aim of informing a later experiential intervention based on Forum Theater. CONCLUSIONS: The lived experience of general surgery residents helped identify cultural factors and behaviors that contribute to and/or mitigate mistreatment providing information to plan interventions at the resident and faculty level. Mitigating or stopping mistreatment can improve the Clinical Learning Environment and hence, the quality of training.
KW - Professionalism training
KW - clinical learning environment
KW - mistreatment in graduate medical education
KW - qualitative research
KW - surgical education
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U2 - 10.1016/j.jsurg.2022.10.013
DO - 10.1016/j.jsurg.2022.10.013
M3 - Article
C2 - 36400690
AN - SCOPUS:85142204741
SN - 1931-7204
VL - 80
SP - 385
EP - 392
JO - Journal of Surgical Education
JF - Journal of Surgical Education
IS - 3
ER -