The Survey Of Medical Student Abuse And Influence Factors During Medical Clinical Clerkships In Hunan Province

Objective: To investigate the information of medical student abuse during clinical clerkships in Hunan province. To approach the relationship between medical student abuse and depression or anxiety in abused students.Method: A questionnaire was developed with vignettes describing abusive situations that medical students could have met during medical clinical clerkships. The questionnaire was handed to students with 2 other rating scales: self-rating depression scale and self-rating anxiaty scale. The study population comprised 329 medical students in 8 teaching hospitals in Hunan province. These questionnaires were answered anonymously and returned as soon as finished to ensure confidentiality.Result: Of the 329 students surveyed, 312 questionnaires were available, the response rate was 94.8%. Of the respondents, 244 (78.2%) students reported at least one instance of abuse, 80.0% of the men (n=116)and 76.6% of the women(n=128) had experienced at least one instance of abuse. In all five types of medical student abuse we investigated: verbal abuse, physical abuse, academic abuse, sexual harassment and gender discrimination, verbal abuse (n=210,67.3%)was the most common type of medical student abuse which followed by academic abuse (n=165,52.9%) , gender discrimination (n=105,33.7%), sexual harassment (n=91,29.2%) and physical abuse (n=60,19.2%) .In the sources of perpetrators, attending physician(17%) and nurse(17%) were identified the most frequently as the sources of perpetrators which followed by Patients( 16.3%), resident physician(16.2%), others(12.7%), chief physician or professor (9.3%) , peers (5%) , meditech technician (4%) and service personnel (2.5%) . In the sources of abusive site, surgical department(29.5%) was reported the most common abusive site which followed by department of internal medicine (22.8%) , obstetric and gynecologic department (14.4%) , others (13.5%) , department of pediatrics (6.8%), emergency department (5.4%), infection department (4.1%) and anaesthesiology department (3.4%) . Kruskal-Wallis H test showd that self-rating depression scale scores among academic abuse groups (x~2=9.74,p=0.02) and numbers of abuse type groups(x~2 =33.55, p=0.00) were significant; the self-rating anxiety scale scores among vebal abuse groups(x~2 =9.85,p=0.00), physical abuse groups(x~2=9.49,p=0.00), sexual harassment groups (x~2=15.96,p=0.00) and numbers of abuse type groups(x~2 =37.96,p=0.00) were significant. Nemenyi test showed that in academic abuse groups, the self-rating depression scale score of group 4 was higher than group 1; in numbers of abuse type groups, the self-rating depression scale score of group 4,group 5 and group 6 were higher than group 1, the self-rating depression scale score of group 6 was higher than group 2 and group 3. Nemenyi test showed that in verbal abuse groups and physical abuse groups, the self-rating anxiety scale score of group 3 was higher than group 1 and group 2, in sexual harassment groups, the self-rating anxiety scale score of group 4 was higher than group 1; in numbers of abuse type groups, the self-rating anxiety score of group 4,group 5 and group 6 were higher than group 1, the self-rating anxiety scale score of group 6 was higher than group 2 and group 3.Conclusion: The phenomenon of medical student abuse is common in Hunan province. Male experience more sexual harassment than female, there are no difference between male and female in other types of medical student abuse. Academic abuse can influence depression symptom; verbal abuse, physical abuse and sexual harassment can influence anxiety symptom.