"That's part of the culture:" A peer-to-peer study of reporting student mistreatment

IntroductionForty percent of graduating medical students report experiencing student mistreatment; however, most cases go unreported. MethodsPeer-to-peer, semi-structured interviews with current medical students were conducted to understand medical students experiences with mistreatment and reporting. These interviews were inductively coded, and themes were identified to elucidate reasons students do and do not report mistreatment. ResultsTwenty-one students were interviewed who described a total of 34 mistreatment incidents. Four main groups of factors that students consider when deciding to report mistreatment were identified: personal, situational, structural, and climate. Personal factors were intrinsically tied to the participant, including their feelings or concerns about mistreatment. Situational factors related to the act of mistreatment, such as who the perpetrator was or the actions of bystanders. Structural factors included elements of the reporting system. Climate factors were concerns related to how the institution viewed mistreatment and the students place in medical education. DiscussionThis peer-to-peer study revealed four main groups of factors, all of which are influenced by the culture of the institution. Participants were impacted by the inactions of witnesses and their personal sense of justice. An approach to facilitating reporting of student mistreatment must be grounded in improving the culture of medical education.