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Violence and Clinical Learning Environments in Medical Residencies

Author

Listed:
  • Liz Hamui-Sutton

    (Division of Graduate Studies, Faculty of Medicine, National Autonomous University of Mexico, Unidad de Posgrado, Coyoacán, Mexico City 04510, Mexico)

  • Francisco Paz-Rodriguez

    (Laboratory of Clinical Neuropsychology, National Institute of Neurology and Neurosurgery, Av. Insurgentes Sur 3877, La Fama, Tlalpan, Mexico City 14269, Mexico)

  • Alejandra Sánchez-Guzmán

    (Division of Graduate Studies, Faculty of Medicine, National Autonomous University of Mexico, Unidad de Posgrado, Coyoacán, Mexico City 04510, Mexico)

  • Tania Vives-Varela

    (Department of Research in Medical Education, Faculty of Medicine, National Autonomous University of Mexico, Av. Universidad 3000, Coyoacán, Mexico City 04510, Mexico)

  • Teresa Corona

    (Division of Graduate Studies, Faculty of Medicine, National Autonomous University of Mexico, Unidad de Posgrado, Coyoacán, Mexico City 04510, Mexico
    Clinical Laboratory of Neurodegenerative Diseases, National Institute of Neurology and Neurosurgery, Av. Insurgentes Sur 3877, La Fama, Tlalpan, Mexico City 14269, Mexico)

Abstract

Introduction: The objective of this study was to describe and analyze residents’ perceptions of characteristics on the expansive/restrictive continuum of their clinical learning environment. Methods: We conducted a quantitative, descriptive and cross-sectional study. A self-administered questionnaire was designed, programmed and applied to residents at the Faculty of Medicine of the National Autonomous University of Mexico. The instrument was structured in eight sections, and for this article, Section 3, which referred to clinical environments and violence was considered. The questionnaire had an 85% response rate, with 12,612 residents from 113 medical units and 78 specialties participating. The reliability and internal consistency measured with alpha omega obtained a value of ω 0.835 (CI; 0.828–0.843). Results: Unpleasant, competitive, tense and conflictive contexts were related to restrictive environments. Sexual orientation influenced the perception of intolerance in the clinical setting with respect to discriminatory comments, such that for gender minorities, the environment was experienced as exclusionary. First-year residents perceived environments as more aggressive, a perception that tended to decrease in later years of residency. Discussion: Abuses in power relations, rigid hierarchical positions and offensive clinical interactions may foster restrictive environments. In such settings, the reproduction of socio-culturally learned violence is feasible; however, asymmetrical relationships may be deconstructed and transformed.

Suggested Citation

  • Liz Hamui-Sutton & Francisco Paz-Rodriguez & Alejandra Sánchez-Guzmán & Tania Vives-Varela & Teresa Corona, 2023. "Violence and Clinical Learning Environments in Medical Residencies," IJERPH, MDPI, vol. 20(18), pages 1-15, September.
  • Handle: RePEc:gam:jijerp:v:20:y:2023:i:18:p:6754-:d:1238969
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    References listed on IDEAS

    as
    1. Jose Miguel Giménez Lozano & Juan Pedro Martínez Ramón & Francisco Manuel Morales Rodríguez, 2021. "Doctors and Nurses: A Systematic Review of the Risk and Protective Factors in Workplace Violence and Burnout," IJERPH, MDPI, vol. 18(6), pages 1-19, March.
    2. Núria Rovira-Asenjo & Agnieszka Pietraszkiewicz & Sabine Sczesny & Tània Gumí & Roger Guimerà & Marta Sales-Pardo, 2017. "Leader evaluation and team cohesiveness in the process of team development: A matter of gender?," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-20, October.
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