Mistreatment Support within Clinical Learning Environments

Endorsed In: 
May, 2021
Paper Type: 
Position Paper

Download: Click here to access the full paper


  • Shaily Brahmbhatt (Western University) 
  • Andrew Jeong (Western University)
  • Andrea Vucetic (Western University)

Background: ​

Mistreatment is defined by the American Association of Medical Colleges (AAMC) as “an intentional or unintentional event that occurs when behaviour shows disrespect for the dignity of others and unreasonably interferes with the learning process”. According to the AAMC, examples include sexual harassment; discrimination or harassment based on race, religion, ethnicity, gender, or sexual orientation; humiliation; psychological or physical punishment; and the use of grading and other forms of assessment in a punitive manner. At times, such experiences of mistreatment can be classified as microaggressions, which are defined as subtle actions, words, or behaviours enacted towards marginalized groups that may arise from unconscious biases, prejudices, or hostility, and ultimately lead to serious and negative impacts on the psychological well-being of the recipient. 

The Ontario Medical Students Association makes its recommendations using the following guiding principles:

  1. All individuals in the workplace can potentially contribute to student mistreatment, including peers, staff, faculty, and patients. 
  2. Educators, students, and healthcare professionals should receive training to identify their implicit biases and their impact on interprofessional relationships with learners from marginalized communities.
  3. Medical schools and hospital training materials should prepare medical students to respond to mistreatment in the workplace. 
  4. Learners from marginalized communities should have access to culturally safe supports within their clinical learning environments.


  • Hospital training procedures and medical education should incorporate preventative measures for all potential sources of mistreatment towards medical learners, including from peers, staff, and patients.
  • Undergraduate medical education and clinical resources should educate learners on how to identify different types of mistreatment and enhance transparency in reporting policies to empower learners from marginalized communities to report instances of mistreatment.
  • Clinical learning environments, including hospital and community-based settings, should ensure access to safe peer support for marginalized learners in clerkship and residency.