WS9 - 02: COMBATING MISTREATMENT: UNDERSTANDING UNDERLYING MECHANISMS OF MISTREATMENT AND DESIGNING FOCUSED INTERVENTIONS
Brittany Hasty, Sylvia Bereknyei Merrell, DrPH, Edmund Lee, MD, Dana Lin, MD, James Lau, MD, MHPE; Stanford University

Background: Since mistreatment has been reported and trended, the surgical specialties have been implicated at particularly high rates. Addressing trainee mistreatment is of critical importance given its associations with burnout, depression, post-traumatic stress, substance use, and erosion of confidence in clinical skills. Despite recognition of the deleterious effects of medical student mistreatment, few programs exist to combat mistreatment, and those that do are often found to be ineffective.

One barrier to implementing effective mistreatment programs is the lack of consideration of the underlying mechanisms of mistreatment. Traditional definitions are often limited to discrete acts, and do not include the subtle and more difficult-to-document incidents that medical students report as being harmful to them in the surgical learning environment.

Beginning in 2014, our institution began implementing a mistreatment curriculum for students on their surgery clerkship. The program has been well-reviewed by students, who felt it improved the learning environment and increased interest in the field of surgery. In the years since the program was instituted, reported incidents of mistreatment have decreased. 

Goals and Objectives: This workshop is intended provide learners with an understanding of medical student perceptions of mistreatment, as well as to offer specific tools and strategies for the development of mistreatment interventions or curricula. 

At the end of this workshop, participants will be able to:

1. Describe the underlying mechanisms of medical student mistreatment
2. Define mistreatment for themselves and their institutions
3. Understand how medical students cope with mistreatment in the surgery clerkship
4. Implement components of one successful mistreatment intervention program to address mistreatment in their own institutions.

Workshop Structure and Content: The workshop will allow participants to reflect on their own understanding of medical student mistreatment and provide them with strategies to develop effective mistreatment interventions. The session will be interactive, with participants having an opportunity to share their own experiences with medical student mistreatment and interventions. We will introduce participants to the definitions generated by students at our institution, as well as the components of our mistreatment program, specifically (1) the use of trigger videos, (2) facilitated discussions, (3) communication strategies, and 4) institutional leadership.