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“Teaching by humiliation” and mistreatment of medical students in clinical rotations: a pilot study

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The development of professionalism is currently a topic of interest in medical education research and often an explicit goal in medical curricula. Yet for over 25 years, research into the teaching of students and junior doctors has reported the presence of humiliation, intimidation, harassment and abuse,1 which undermine the teaching of professionalism.2 Early research identified forms of abuse ranging from subtle acts, such as derogatory remarks and undermining students’ abilities and motivation, to more overt behaviour, including verbal attacks, yelling and nasty or rude behaviour.3,4 Subsequent research reported that students were publicly belittled, humiliated or threatened with physical harm;2 had their reputation or career threatened; or experienced unjustified criticism, sarcasm and teasing.5 Some medical staff reportedly withheld necessary information, ignored students and set impossible deadlines.5

More recent research has identified practices including teaching by humiliation,6 contempt, belittlement,7 harassment, discrimination, assault,8 mocking and scorn,9