Empowering Medical Students to Address Patient-Initiated Mistreatment at the Transition to Residency: An Education Quality Improvement Study

Background

Mistreatment from patients is prevalent and has far-reaching negative consequences.

Aim

To develop a practice-based curriculum on patient-initiated mistreatment and examine participant perceptions before and after the curriculum.

Setting

Single medical school in the United States.

Participants

306 senior medical students from classes 2022 and 2023.

Program Description

A single patient-initiated mistreatment session delivered during specialty-specific residency preparation courses (RPCs) featuring a literature discussion, a response framework, and patient-actor skills practice.

Program Evaluation

Between February 2022 and October 2023, 22 sessions occurred. Electronic surveys were delivered before, following, and approximately eight months after each session. A total of 257 (84.0%) and 174 (56.9%) participants completed pre- and post-session surveys, respectively. Significant increases in mean scores were noted for confidence in recognizing mistreatment (pre-session 4.25, post-session 4.68; p < 0.001) and comfort in addressing mistreatment personally (pre-session 2.86, post-session 4.30; p < 0.001) and as a bystander (pre-session 2.98, post-session 4.27; p < 0.001). In the follow-up survey, participants noted that the session was useful in preparing them for residency.

Discussion

A novel patient-initiated mistreatment curriculum empowered students, resulting in enhanced confidence in responding and sustained skill usage. Medical schools may consider including this training for all graduating students.