Purpose: To evaluate the impact of bystander intervention (BI) training on medical student evaluations of faculty professionalism and the learning environment.
Background: Bystander intervention training gives trainees tools to recognize power-based violence (PBV) in many forms and de-escalate. BI may offer medical professionals a skill set that promotes a more sensitive and professional clinical learning environment.
Methods: BI training through the Green Dots program was completed by the Vanderbilt OBGYN residents in April 2019 and faculty in July 2019. Medical student clerkship evaluation data was routinely collected before and after training and was de-identified. Questions regarding sensitivity of the clinical learning environment were compared for periods 12 months before and 12 months after resident training. Questions regarding faculty professionalism and behaviors were compared for the same seasonal 6 months (Sept-Feb) before and after faculty training. This study was granted IRB approval under exempt status with special considerations for protected student data under FERPA requirements.
Results: After resident BI training, the percentage of clerkship students who felt that the clinical learning environment reflected sensitivity to issues of culture, gender, race, religion and sexual orientation/identity increased from 82.7% to 87.4% (p=0.35), increasing from 82.7% pre-training to 85.7% after resident training, and 88.7% after faculty training.
Looking at faculty evaluation data, more students felt that faculty professional behavior matched expectations after BI training (69.8% vs 51.6%, p=0.05). While the percentage of students who felt faculty respected diversity decreased slightly after training (97.4% vs 88.5%, p=0.14), the number of students who felt faculty showed respectful interactions with students increased after training (87.0% vs 94.3%, p=0.20).
Discussions: BI training for residents and faculty improved medical students’ perception of the sensitivity of the clerkship clinical learning environment with an additive effect when both residents and faculty completed training. After faculty BI training, more clerkship students felt that faculty professionalism approximated expectations and felt that faculty demonstrated respectful interactions. Although the small sample size and single institution experience limit the statistical power, there is a trend toward improvement in professionalism and a sensitive learning environment. BI training may offer additional tools to improve the learning environment.
Topics: CREOG & APGO Annual Meeting, 2021, Student, Resident, Faculty, Clerkship Director, Residency Director, Professionalism, Interpersonal & Communication Skills, GME, UME,
Celeste Hemingway, MD, MHPE, Vanderbilt University Medical Center; Nicola White, MD
