Students as pawns: A qualitative study of the impacts of encountering incivility on medical students during clinical placements.

Background: Incivility is a pervasive issue in healthcare, known to affect patient safety and clinician wellbeing. However, its impact on medical students during clinical placements remains underexplored. This study investigates how experiences of incivility influence medical students' sense of belonging and professional identity.

Methods: Using reflexive thematic analysis, qualitative data from 58 final-year medical students at an Australian university was analysed. Data was gathered through open-ended online surveys that invited students to describe their experiences of conflict and its impacts.

Results: Two overarching themes emerged: Students as pawns in the belonging games of healthcare workers and The belonging games of students as foreigners in the healthcare world. Students often found themselves excluded, targeted, or witnessing interprofessional conflict. These experiences undermined their sense of belonging, hindered their learning, and contributed to emotional distress. Students responded with various strategies: seeking affiliation, performing facework, or choosing to disaffiliate entirely.

Conclusions: This study highlights the emotional burden and identity challenges faced by medical students navigating clinical placements. The concept of 'belonging work' offers a new lens for understanding these dynamics. Educational interventions that foster positive belonging and prepare students for conflict may enhance wellbeing and professional identity development.