Future of Medical Education Journal

Future of Medical Education Journal

Bullying behaviors among medical sciences students in clinical settings: a cross-sectional study

Document Type : Original Article

Authors
Mohammadreza Dinmohammadi 1
Maryam Mohammadi 2
Lida Sasani 3
Mehran Tahrekhani 2
1 Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
2 Department of Nursing Education, Abhar School of Nursing, Zanjan University of Medical Sciences, Zanjan, Iran
3 Young Researchers and Elite Club, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
10.22038/fmej.2023.75383.1566
Abstract
Background: The prevalence of bullying behaviors in clinical education environments is an important obstacle for students' learning, because it has severe psychological consequences. This study was conducted with the aim of determining the incidence of bullying behaviors among medical students in clinical education environments.
Method: This cross-sectional study was conducted in 2019-2020 among medical, undergraduate nursing, midwifery, operating room technology, and anesthesiology students. The research environment consisted of selected teaching hospitals in Zanjan city, Iran, while the sampling method was stratified random sampling. Data were collected using the 18-item Bullying Behaviors in Nursing Education (BBNE) questionnaire and analyzed using SPSS software version 24.
Results: Of the 391 participants, the majority (% 61.9) were women, single, with an average age of 22.88±1.71 years. The total bullying score was 16.46±13.44, which was considered low on the range of 0-90. The dimension of aggression towards the student's personality had the highest score of 7.29±6.54. A significant relationship existed between the total bullying score and age, field of study, marital status, place of residence, and semester (P<0.05).
Conclusion: The findings indicated a low occurrence of bullying among medical students. Additionally, those who were married, older, and highly educated were more vulnerable to being bullied. Universities ought to improve students' capacity to recognize bullying in clinical education surroundings and instruct them on how to react.
Keywords
Bullying
Learning
Medical students
Clinical environment
Violence
Subjects
  1. Karami A, Farokhzadian J, Foroughameri G. Nurses’ professional competency and organizational commitment: Is it important for human resource management? PloS one. 2017;12(11):e0187863.
  2. Djermester P, Gröschke C, Gintrowicz R, Peters H, Degel A. Bedside teaching without bedside–an introduction to clinical reasoning in COVID-19 times. GMS J Med Educ. 2021;38(1).
  3. Phuma-Ngaiyaye E, Bvumbwe T, Chipeta MC. Using preceptors to improve nursing students' clinical learning outcomes: a Malawian students' perspective. International journal of nursing sciences. 2017;4(2):164-8.
  4. Beigzadeh A, Yamani N, Bahaadinbeigy K, Adibi P. Challenges and Problems of Clinical Medical Education in Iran: A Systematic Review of the Literature. Strides in Development of Medical Education. 2019;16(1):1-15.
  5. Zhao W, He L, Deng W, Zhu J, Su A, Zhang Y. The effectiveness of the combined problem-based learning (PBL) and case-based learning (CBL) teaching method in the clinical practical teaching of thyroid disease. BMC med educ. 2020;20:1-10.
  6. Kaufman DM. Teaching and learning in medical education: how theory can inform practice. Understanding medical education: evidence, theory, and practice. 2018:37-69.
  7. Farzi S, Shahriari M, Farzi S. Exploring the challenges of clinical education in nursing and strategies to improve it: A qualitative study. J Educ Health Promot. 2018;7:115.
  8. Newton JM, Billett S, Jolly B, Ockerby CM. Lost in translation: Barriers to learning in health professional clinical education. Learning in Health and Social Care. 2009;8(4):315-27.
  9. Amini A, Bayat R, Amini K. Barriers to clinical education from the perspective of nursing students in Iran: an integrative review. Archiv Pharm Pract. 2020;1:73.
  10. Shadadi H, Sheyback M, Balouchi A, Shoorvazi M. The barriers of clinical education in nursing: A systematic review. Biomed Res. 2018;29(19):3616-23.
  11. Salmani F, Eghbali B, Ganjifard M, Mohammadi Y, Kafian Atary S, et al. Barriers to quality of clinical education from the viewpoints of medical students of Birjand University of Medical Sciences in the academic year 2018-2019. Journal of Birjand University of Medical Sciences. 2020;27(1):100-9. Persian.
  1. Bogren M, Alesö A, Teklemariam M, Sjöblom H, Hammarbäck L, Erlandsson K. Facilitators of and barriers to providing high-quality midwifery education in South-East Asia—An integrative review. Women and Birth. 2022;35(3):e199-e210.
  2. AlMulhim AA, Nasir M, AlThukair A, AlNasser M, Pikard J, Ahmer S, et al. Bullying among medical and nonmedical students at a university in Eastern Saudi Arabia. Journal of family & community medicine. 2018;25(3):211-6.
  3. Tahrekhani M, Dinmohammadi M. Bullying among medical sciences students in clinical placements. Journal of Medical Education Development. 2024;17(53):54-62.
  4. Pörhölä M, Cvancara K, Kaal E, Kunttu K, Tampere K, Torres MB. Bullying in university between peers and by personnel: cultural variation in prevalence, forms, and gender differences in four countries. Social Psychology of Education. 2020;23(1):143-69.
  5. Amoo SA, Menlah A, Garti I, Appiah EO. Bullying in the clinical setting: Lived experiences of nursing students in the Central Region of Ghana. PLoS one. 2021;16(9):e0257620.
  6. Kim HH, Chun J. Bullying Victimization, School Environment, and Suicide Ideation and Plan: Focusing on Youth in Low- and Middle-Income Countries. The Journal of adolescent health : official publication of the Society for Adolescent Medicine. 2020;66(1):115-22.
  7. Johansson B, Flygare E, Hellfeldt K. Pass or fail? A study concerning how experiences of bullying, truancy and social relations influence pupils’ academic performance: Friends international center against bullying & Örebro university; 2018. 1-78 p.
  8. Mamaghani EA, Rahmani A, Hassankhani H, Zamanzadeh V, Campbell S, Fast O, et al. Experiences of Iranian nursing students regarding their clinical learning environment. Asian nursing research. 2018;12(3):216-22.
  9. Winston ME. Student Registered Nurse Anesthetists' Perceptions of Bullying and its Impact on Learning. 2017.
  10. Al Omar M, Salam M, Al-Surimi K. Workplace bullying and its impact on the quality of healthcare and patient safety. Human resources for health. 2019;17(1):1-8.
  11. Minton C, Birks M. “You can't escape it”: bullying experiences of New Zealand nursing students on clinical placement. Nurse educ today. 2019;77:12-7.
  12. Abdollahi Z, Barkhordari SM, Nasiriani K, Fallahzadeh H. Investigation of bullying behaviors in clinical settings from the nursing students' views. Iranian Journal of Medical Education. 2020;20(11):91- 104. Persian.
  13. Henning MA, Stonyer J, Chen Y, Alsop-Ten Hove B, Moir F, Webster CS. Medical Students' Experience of Harassment and Its Impact on Quality of Life: a Scoping Review. Medical science educator.2021;31(4):1487-99.
  1. Ng K, Franken E, Nguyen D, Teo S. Job satisfaction and public service motivation in Australian nurses: the effects of abusive supervision and workplace bullying. The International Journal of Human Resource Management. 2022:1-30.
  2. Messiaen M, Duba A, Boulangeat C, Boucekine M, Bourbon A, Viprey M, et al. Repeated bullying at the workplace in medical students and young doctors: the MESSIAEN national study. European archives of psychiatry and clinical neuroscience. 2021;271(6):1123-31.
  3. Rodríguez-Almagro J, Hernández-Martínez A, Romero-Blanco C, Martínez-Arce A, Prado-Laguna MdC, García-Sanchez FJ. Experiences and perceptions of nursing students during the COVID-19 crisis in Spain. International journal of environmental research and public health. 2021;18(19):10459.
  4. Costa EFdO, Mendes CMC, Andrade TMd. Common mental disorders in medical students: A repeated cross-sectional study over six years. Revista da Associação Médica Brasileira. 2017;63:771-8.
  5. Dilek Y, Aytolan Y. Development and psychometric evaluation of workplace psychologically violent behaviours instrument. Journal of clinical nursing. 2008;17(10):1361-70.
  6. Cerit K, Keskin ST, Ekici D. Development of instrument of bullying behaviors in nursing education based on structured equation modeling. Asian nursing research. 2018;12(4):245-50.
  7. Leymann H. Mobbing and psychological terror at workplaces. Violence and victims. 1990;5(2):119-26.
  8. Fox S, Stallworth LE. Racial/ethnic bullying: Exploring links between bullying and racism in the US workplace. Journal of vocational behavior. 2005;66(3):438-56.
  9. Davenport N, Schwartz RD, Elliott GP. Mobbing: Emotional abuse in the American workplace: Civil Society Pub; 1999.
  10. Niedl K. Mobbing and well-being: Economic and personnel development implications. European journal of work and organizational psychology. 1996;5(2):239-49.
  11. Ülker S, Buldukoğlu K, Aksayan S, Atalay M, Kocaman G, Oktay S, et al. Türkiye’de hemşirelik: Temel mesleki eğitim ile insan gücü’ne ilişkin sorunlar ve çözüm önerileri. Ankara Erişim Tarihi. 2001;9:2006. Turkish.
  12. Zapf D, Knorz C, Kulla M. On the relationship between mobbing factors, and job content, social work environment, and health outcomes. European Journal of work and organizational psychology. 1996;5(2):215-37.
  13. Abdelaziz EM, Abu‐Snieneh HM. The impact of bullying on the mental health and academic achievement of nursing students. Perspectives in psychiatric care. 2022;58(2):623-34.
  14. Ahmer S, Yousafzai AW, Bhutto N, Alam S, Sarangzai AK, Iqbal A. Bullying of medical students in Pakistan: a cross-sectional questionnaire survey. PLoS one. 2008;3(12):e3889.
  15. Frank E, Carrera JS, Stratton T, Bickel J, Nora LM. Experiences of belittlement and harassment and their correlates among medical students in the United States: longitudinal survey. bmj. 2006;333(7570):682.
  16. Fathi M, Fallahi A, Sharifi S, Dehghani S, Olyaei N, Valiee S. Status of violence in a selected faculty: the students’ experience. International journal of nursing education scholarship. 2018;15(1):1-10.
  17. Hakojärvi H-R, Salminen L, Suhonen R. Health care students' personal experiences and coping with bullying in clinical training. Nurse educ today. 2014;34(1):138-44.
  18. Akcana G, Öztürk E. The Investigation of Predictors of Cyber Bullying and Cyber Victimization in University Students. Turkiye Klinikleri J Foren Sci Leg Med. 2020;17(1):47-57.
  19. Qamar K, Khan NS, Bashir Kiani M. Factors associated with stress among medical students. JPMA The Journal of the Pakistan Medical Association. 2015;65(7):753-5.
  20. Myers C-A, Cowie H. Cyberbullying across the lifespan of education: Issues and interventions from school to university. International journal of environmental research and public health. 2019;16(7):1217.
Future of Medical Education Journal
Volume 14, Issue 1
Winter 2024
Pages 9-14