title: A Mixed-Methods Analysis of a Novel Mistreatment Program for the Surgery Core Clerkship.
abstract: To review mistreatment reports from before and after implementation of a mistreatment program, and student ratings of and qualitative responses to the program to evaluate the short-term impact on students.
  
  
  
  In January 2014, a video- and discussion-based mistreatment program was implemented for the surgery clerkship at the Stanford University School of Medicine. The program aims to help students establish expectations for the learning environment; create a shared and personal definition of mistreatment; and promote advocacy and empower ment to address mistreatment. Counts and types of mistreatment were compared from a year before (January-December 2013) and two years after (January 2014-December 2015) implementation. Students' end-of-clerkship ratings and responses to open-ended questions were analyzed.
  
  
  
  From March 2014-December 2015, 141/164 (86%) students completed ratings, and all 47 (100%) students enrolled from January-August 2014 provided qualitative program evaluations. Most students rated the initial (108/141 [77%]) and final (120/141 [85%]) sessions as excellent or outstanding. In the qualitative analysis, students valued that the program helped establish expectations; allowed for sharing experiences; provided formal resources; and provided a supportive environment. Students felt the learning environment and culture were improved and reported increased interest in surgery. There were 14 mistreatment reports the year before the program, 9 in the program's first year, and 4 in the second year.
  
  
  
  The authors found a rotation-specific mistreatment program, focused on creating shared understanding about mistreatment, was well received among surgery clerkship students, and the number of mistreatment reports decreased each year following implementation.
authors.affiliation: J.N. Lau is clinical associate professor, Goodman Surgical Education Center, Department of Surgery, Stanford University School of Medicine, Stanford, California. L.M. Mazer is a surgical resident, Goodman Surgical Education Center, Department of Surgery, Stanford University School of Medicine, Stanford, California. C.A. Liebert is a surgical resident, Goodman Surgical Education Center, Department of Surgery, Stanford University School of Medicine, Stanford, California. S. Bereknyei Merrell is research scholar, Goodman Surgical Education Center, Departments of Surgery and of Research and Evaluation, Office of Medical Education, Stanford University School of Medicine, Stanford, California. D.T. Lin is clinical assistant professor, Goodman Surgical Education Center, Department of Surgery, Stanford University School of Medicine, Stanford, California. I. Harris is professor, Department of Medical Education, University of Illinois-Chicago College of Medicine, Chicago, Illinois.
authors.forename: James N
authors.initials: JN
authors.lastname: Lau
authors.forename: Laura M
authors.initials: LM
authors.lastname: Mazer
authors.forename: Cara A
authors.initials: CA
authors.lastname: Liebert
authors.forename: Sylvia
authors.initials: S
authors.lastname: Bereknyei Merrell
authors.forename: Dana T
authors.initials: DT
authors.lastname: Lin
authors.forename: Ilene
authors.initials: I
authors.lastname: Harris
mesh_terms: D000328:Adult; D002140:California; D002982:Clinical Clerkship / Q000458:organization & administration*; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000458:organization & administration*; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D013337:Students, Medical / Q000523:psychology*; D055815:Young Adult