AAMC:  “Is it Mistreatment?”

December 11, 2023

AAMC:  “Is it Mistreatment? Practices for Productive Teacher-Learner Interactions”

Mistreatment is complicated

  • It is personal and involves¹
  • It is not limited to negative feedback or
  • It can occur unintentionally during

AVOID these unproductive attitudes and strategies

  • Offensive/misinterpreted behaviors: Touching, vulgarity, or personal errands
  • Overgeneralizations: Concluding that differences in perception mean someone will inevitably be offended, so why attend to words so closely
  • Personalization’s: Conveying the sentiment that mistreatment prepared you for life
  • Frustrations: Sharing regrets that learners are simply oversensitive to any criticism
  • Complaints: Using generational differences or political correctness as a justification for mistreatment
  • Ignoring learners/avoiding feedback: Sidestepping difficult feedback conversations, which is unhelpful and often viewed as dismissive3
  • Relying too heavily on humor: Joking as a means to build camaraderie, but which may be misinterpreted, may be at another’s or a group’s expense, and may be offensive

The Mistreatment diagram shows what type of interactions to emphasize to be perceived as supportive versus avoid to be perceived as mistreatment. Emphasizing interactions seen to be supportive include: applying behaviors that are professional, respectful, humanistic, and of an expert teacher. Interactions to avoid being seen as mistreatment include: providing feedback without suggestions, focusing criticism on learner's fault, basing critique on value judgements, providing emotionally charged criticism, conveying criticism in public rather than in private, blindsiding learner with criticism too late for improvement, exploiting power, stereotyping remarks, discriminating treatment, providing vague instructions, focusing criticism on areas beyond learner's control, and assuming expectations are obvious without direction.

References:

  1. Gan R, Snell L. When the learning environment is suboptimal: Exploring medical students’ perceptions of “mistreatment.” Acad Med. 2014;89:608–617.
  2. Bynum WE 4th, Artino AR Jr, Uijtdehaage S, Webb AMB, Varpio L. Sentinel emotional events: The nature, triggers, and effects of shame experiences in medical residents. Acad Med. 2019;94:85–93.
  3. Buery-Joyner SD, Ryan MS, Santen SA, Borda A, Webb T, Cheifetz Beyond mistreatment: Learner neglect in the clinical teaching environment. Med Teach. 2019;41:949–955.

Author contact: [email protected]

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