title: Making fun of patients: medical students' perceptions and use of derogatory and cynical humor in clinical settings.
abstract: OBJECTIVE
  It has long been known that medical students become more cynical as they move through their training, and at times even exhibit "ethical erosion." This study examines one dimension of this phenomenon: how medical students perceive and use derogatory and cynical humor directed at patients.
  
  
  METHODS
  The authors conducted five voluntary focus groups over a three-month period with 58 third- and fourth-year medical students at the Northeastern Ohio Universities College of Medicine in 2005. After transcribing the taped interviews, the authors analyzed the data using qualitative methods and identified themes found across groups.
  
  
  RESULTS
  The categories that emerged from the data were (1) categories of patients who are objects of humor, including those deemed "fair game" due to obesity or other conditions perceived as preventable or self-inflicted; (2) locations for humor; (3) the "humor game," including student, resident, and faculty interaction and initiation of humor; (4) not-funny humor; and (5) motives for humor, including coping and stress relief.
  
  
  CONCLUSIONS
  The authors offer recommendations for addressing the use of derogatory humor directed at patients that include a more critical, open discussion of these attitudes and behaviors with medical students, residents, and attending physicians, and more vigorous attention to faculty development for residents.
authors.affiliation: Northeastern Ohio Universities College of Medicine, Rootstown, Ohio, USA.
authors.forename: Delese
authors.initials: D
authors.lastname: Wear
authors.forename: Julie M
authors.initials: JM
authors.lastname: Aultman
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Varley
authors.forename: Joseph
authors.initials: J
authors.lastname: Zarconi
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D005260:Female; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D028642:Persons with Psychiatric Disorders; D009767:Obesity, Morbid; D009820:Ohio; D010817:Physician-Patient Relations; D011787:Quality of Health Care; D012938:Social Perception; D012962:Sociology, Medical; D013240:Stereotyping; D013337:Students, Medical / Q000523:psychology*; D014925:Wit and Humor as Topic