Addressing medical resident mistreatment: A resident-centred approach.

Introduction: Mistreatment negatively impacts the wellbeing of medical learners and is related to worse patient outcomes and team functioning. Resident perspectives on improving mistreatment reporting structures and investigations have not been explored. We aimed to understand residents' views on safe reporting structures, investigations, and resolution processes.

Method: We conducted an exploratory sequential mixed method study beginning with a series of qualitative interviews to inform an anonymous online survey to all Dalhousie University residents (N = 645).

Results: When interviewed, residents (N = 10) discussed personal experiences with mistreatment, barriers to reporting, and how these processes could better serve them. Themes from the interviews were imbedded in an anonymous online survey to explore their prevalence among a larger group. Residents (N = 120; 19%) completed the online survey and revealed that mistreatment was very common yet underreported. Barriers to reporting included confidentiality concerns, perceptions that reporting would not change anything, and fear of retaliation. Desired outcomes for perpetrators depended on the perpetrator's position and incident severity, and most prefer a remedial approach.

Conclusion: Resident mistreatment remains prevalent and current processes of dealing with reports may be inadequate. Residents have thoughtful insights for improving institutional policies and procedures and should be meaningfully engaged.