The Association of Microaggressions with Depressive Symptoms and Institutional Satisfaction Among a National Cohort of Medical Students.
diversity and inclusion
medical education
mental health
microaggressions
physician burnout
physician workforce
Journal
Journal of general internal medicine
ISSN: 1525-1497
Titre abrégé: J Gen Intern Med
Pays: United States
ID NLM: 8605834
Informations de publication
Date de publication:
02 2022
02 2022
Historique:
received:
24
10
2020
accepted:
31
03
2021
pubmed:
4
5
2021
medline:
12
3
2022
entrez:
3
5
2021
Statut:
ppublish
Résumé
Despite substantial research on medical student mistreatment, there is scant quantitative data on microaggressions in US medical education. To assess US medical students' experiences of microaggressions and how these experiences influenced students' mental health and medical school satisfaction. We conducted a cross-sectional, online survey of US medical students' experiences of microaggressions. The primary outcome was a positive depression screen on the 2-item Patient Health Questionnaire (PHQ-2). Medical school satisfaction was a secondary outcome. We used logistic regression to model the association between respondents' reported microaggression frequency and the likelihood of a positive PHQ-2 screen. For secondary outcomes, we used the chi-squared statistic to test associations between microaggression exposure and medical school satisfaction. Out of 759 respondents, 61% experienced at least one microaggression weekly. Gender (64.4%), race/ethnicity (60.5%), and age (40.9%) were the most commonly cited reasons for experiencing microaggressions. Increased microaggression frequency was associated with a positive depression screen in a dose-response relationship, with second, third, and fourth (highest) quartiles of microaggression frequency having odds ratios of 2.71 (95% CI: 1-7.9), 3.87 (95% CI: 1.48-11.05), and 9.38 (95% CI: 3.71-26.69), relative to the first quartile. Medical students who experienced at least one microaggression weekly were more likely to consider medical school transfer (14.5% vs 4.7%, p<0.001) and withdrawal (18.2% vs 5.7%, p<0.001) and more likely to believe microaggressions were a normal part of medical school culture (62.3% vs 32.1%) compared to students who experienced microaggressions less frequently. To our knowledge, this is the largest study on the experiences and influences of microaggressions among a national sample of US medical students. Our major findings were that microaggressions are frequent occurrences and that the experience of microaggressions was associated with a positive depression screening and decreased medical school satisfaction.
Sections du résumé
BACKGROUND
Despite substantial research on medical student mistreatment, there is scant quantitative data on microaggressions in US medical education.
OBJECTIVE
To assess US medical students' experiences of microaggressions and how these experiences influenced students' mental health and medical school satisfaction.
DESIGN AND PARTICIPANTS
We conducted a cross-sectional, online survey of US medical students' experiences of microaggressions.
MAIN MEASURES
The primary outcome was a positive depression screen on the 2-item Patient Health Questionnaire (PHQ-2). Medical school satisfaction was a secondary outcome. We used logistic regression to model the association between respondents' reported microaggression frequency and the likelihood of a positive PHQ-2 screen. For secondary outcomes, we used the chi-squared statistic to test associations between microaggression exposure and medical school satisfaction.
KEY RESULTS
Out of 759 respondents, 61% experienced at least one microaggression weekly. Gender (64.4%), race/ethnicity (60.5%), and age (40.9%) were the most commonly cited reasons for experiencing microaggressions. Increased microaggression frequency was associated with a positive depression screen in a dose-response relationship, with second, third, and fourth (highest) quartiles of microaggression frequency having odds ratios of 2.71 (95% CI: 1-7.9), 3.87 (95% CI: 1.48-11.05), and 9.38 (95% CI: 3.71-26.69), relative to the first quartile. Medical students who experienced at least one microaggression weekly were more likely to consider medical school transfer (14.5% vs 4.7%, p<0.001) and withdrawal (18.2% vs 5.7%, p<0.001) and more likely to believe microaggressions were a normal part of medical school culture (62.3% vs 32.1%) compared to students who experienced microaggressions less frequently.
CONCLUSIONS
To our knowledge, this is the largest study on the experiences and influences of microaggressions among a national sample of US medical students. Our major findings were that microaggressions are frequent occurrences and that the experience of microaggressions was associated with a positive depression screening and decreased medical school satisfaction.
Identifiants
pubmed: 33939079
doi: 10.1007/s11606-021-06786-6
pii: 10.1007/s11606-021-06786-6
pmc: PMC8811096
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
298-307Subventions
Organisme : NHLBI NIH HHS
ID : T35 HL007649
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States
Informations de copyright
© 2021. Society of General Internal Medicine.
Références
JAMA Intern Med. 2015 Oct;175(10):1706-8
pubmed: 26301524
Teach Learn Med. 2014;26(4):350-6
pubmed: 25318029
JAMA Intern Med. 2020 May 1;180(5):653-665
pubmed: 32091540
JAMA. 1990 Jan 26;263(4):533-7
pubmed: 2294325
JAMA Surg. 2019 Oct 1;154(10):952-958
pubmed: 31389989
J Natl Med Assoc. 2009 Dec;101(12):1274-82
pubmed: 20070016
Acad Med. 2014 Mar;89(3):443-51
pubmed: 24448053
J Trauma Stress. 2013 Feb;26(1):119-24
pubmed: 23417879
Pers Soc Psychol Bull. 2011 Dec;37(12):1666-78
pubmed: 21885859
BMJ. 2006 Sep 30;333(7570):682
pubmed: 16956894
Suicide Life Threat Behav. 2015 Oct;45(5):567-576
pubmed: 25556819
J Natl Med Assoc. 2016 Winter;108(4):225-235
pubmed: 27979008
Am Psychol. 2014 Sep;69(6):575-87
pubmed: 25197837
Am Psychol. 2007 May-Jun;62(4):271-86
pubmed: 17516773
Acad Med. 2009 Feb;84(2):236-41
pubmed: 19174678
Am J Epidemiol. 2006 Aug 1;164(3):257-62
pubmed: 16777930
JAMA. 1992 Feb 5;267(5):692-4
pubmed: 1731137
Acad Med. 2014 Nov;89(11):1520-5
pubmed: 25250752
J Psychosom Res. 2005 Feb;58(2):163-71
pubmed: 15820844
Acad Med. 2014 Apr;89(4):573-7
pubmed: 24556765
Acad Med. 2014 May;89(5):817-27
pubmed: 24667512
Acad Med. 2014 May;89(5):705-11
pubmed: 24667505
Cultur Divers Ethnic Minor Psychol. 2012 Apr;18(2):165-70
pubmed: 22506819
JAMA. 2016 Dec 6;316(21):2214-2236
pubmed: 27923088
Am J Public Health. 2008 Jul;98(7):1241-7
pubmed: 18511732
Cultur Divers Ethnic Minor Psychol. 2002 May;8(2):88-102
pubmed: 11987594
Acad Med. 2020 May;95(5):758-763
pubmed: 31725462
JAMA Intern Med. 2017 May 1;177(5):659-665
pubmed: 28264091
Arch Intern Med. 2007 Oct 22;167(19):2103-9
pubmed: 17954805
Cultur Divers Ethnic Minor Psychol. 2012 Jan;18(1):45-54
pubmed: 21967526
Acad Med. 2014 Aug;89(8):1192
pubmed: 24918758
J Couns Psychol. 2011 Oct;58(4):470-80
pubmed: 21875180
Acad Med. 2014 May;89(5):749-54
pubmed: 24667503
Acad Med. 2013 Nov;88(11):1765-77
pubmed: 24072111
Acad Med. 2010 Jan;85(1):103-10
pubmed: 20042835
Med Care. 2003 Nov;41(11):1284-92
pubmed: 14583691
JAMA. 1998 Apr 15;279(15):1194-9
pubmed: 9555759
J Youth Adolesc. 2012 Jul;41(7):831-46
pubmed: 22453294
PLoS One. 2017 Aug 9;12(8):e0181659
pubmed: 28792940
Acad Med. 2005 Oct;80(10 Suppl):S80-3
pubmed: 16199465