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    Intimidation: A Tool of Learning? Do We Learn Better Under The Gun?

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    Budi Iman Santoso
    This document discusses intimidation and bullying in medical education. It presents the results of a survey of 76 obstetrics and gynecology residents at a hospital in Indonesia. The survey found that 50% reported experiencing intimidation, primarily from other residents and consultants. While most residents do not think intimidation is an effective learning tool, 18.8% think it is unnecessary to have policies preventing intimidation. The document concludes that intimidation is a cycle that requires a multi-disciplinary policy approach to prevent its negative impacts on medical education.

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    Intimidation: A Tool of Learning? Do We Learn Better Under The Gun?

    Uploaded by

    Budi Iman Santoso
    64 views39 pages
    This document discusses intimidation and bullying in medical education. It presents the results of a survey of 76 obstetrics and gynecology residents at a hospital in Indonesia. The survey found that 50% reported experiencing intimidation, primarily from other residents and consultants. While most residents do not think intimidation is an effective learning tool, 18.8% think it is unnecessary to have policies preventing intimidation. The document concludes that intimidation is a cycle that requires a multi-disciplinary policy approach to prevent its negative impacts on medical education.

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    intimidasi

    Original Title

    Intimidation

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    This document discusses intimidation and bullying in medical education. It presents the results of a survey of 76 obstetrics and gynecology residents at a hospital in Indonesia. The survey found that 50% reported experiencing intimidation, primarily from other residents and consultants. While most residents do not think intimidation is an effective learning tool, 18.8% think it is unnecessary to have policies preventing intimidation. The document concludes that intimidation is a cycle that requires a multi-disciplinary policy approach to prevent its negative impacts on medical education.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    64 views39 pages

    Intimidation: A Tool of Learning? Do We Learn Better Under The Gun?

    Uploaded by

    Budi Iman Santoso
    This document discusses intimidation and bullying in medical education. It presents the results of a survey of 76 obstetrics and gynecology residents at a hospital in Indonesia. The survey found that 50% reported experiencing intimidation, primarily from other residents and consultants. While most residents do not think intimidation is an effective learning tool, 18.8% think it is unnecessary to have policies preventing intimidation. The document concludes that intimidation is a cycle that requires a multi-disciplinary policy approach to prevent its negative impacts on medical education.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 39

    INTIMIDATION: A TOOL OF LEARNING?

    DO WE LEARN BETTER UNDER THE GUN?



    REVEALING THE UGLY TRUTH AND THE NEED OF INTIMIDATION POLICY

    Budi Iman Santoso, SpOG(K)
    Departemen Obstetri dan Ginekologi FKUI / RSCM
    OUTLINE
    INTRODUCTION
    DEFINITION , TYPE, SYMPTOM
    INTIMIDATION IN MEDICAL EDUCATION
    THE SURVEY
    CONCLUSION
    INTRODUCTION
    INTIMIDATION is always an interesting problem at any level of education
    or simply at any stage of life.

    INTRODUCTION
    At the beginning, everything was beautiful and exciting

    Especially, when receiving the letter of acceptance to the residency
    LATER, ITS ALL ABOUT THE ENDLESS
    NIGHTMARES
    Tight
    schedule
    Unfriendly
    learning
    atmosphere
    Im nothing but 'a piece of s*** with a badge'.
    Lowest
    status in
    hierarchy
    TO SOME OTHERS IT MAY BE
    NOTHING.
    YOU LEARN BETTER UNDER
    THE GUN !!!
    Which is true?
    THE GUN
    INTIMIDATION , HARASSMENT ,
    BULLYING
    Have similar meaning:
    to frighten, threat or hurt a weaker person
    DEFINITION: INTIMIDATION, BULLYING,
    HARASSMENT
    University of New Jersey, Mistry & Latoo, Dan Olweus:
    Is intended to cause harm or distress
    Occurs repeatedly over time
    Occurs in a relationship in which there is an imbalance of power or
    strength
    By definition, INTIMIDATION = NO GOOD

    TYPE OF INTIMIDATION
    SYMPTOMS
    Table 2. Symptoms of intimidation
    Physical Emotional
    Sleeplessness Acute anxiety
    Nausea Feeling isolated
    Migraine/severe
    headaches
    Loss of confidence/self-
    esteem
    Palpitations Depression
    Skin complaints Panic attacks
    Sweating/shaking Anger
    Backache Mood swings
    Loss of appetite Lack of motivation
    Lethargy Suicidal thoughts
    INTIMIDATION AS LEARNING TOOL
    IN MEDICAL EDUCATION

    GOOD BAD
    GOOD INTIMIDATION
    Could be simply named as SUPERVISION
    BAD INTIMIDATION
    It is difficult to settle or even discuss problems in an
    atmosphere of intimidation

    (J.F.Kennedy, 35
    th
    President of US, 1917-1963)
    INTIMIDATION IS A CYCLE
    THE SURVEY

    Research question: Is intimidation a good learning tool?
    Subject: all residents at Department of Obstetri-
    Gynecology, FMUI, Cipto Mangunkusumo Hospital
    Site: Cipto Mangunkusumo Hospital, Jakarta, Indonesia
    Period: End of November Early December 2011
    Method:
    Simple survey by questionnaire
    A questionnaire consists of 3 parts
    8 questions on demographic characteristic
    Statement on definition of intimidation to prevent bias
    15 questions on respondents opinion as bullies, bullied or
    bystanders
    RESULTS AND DISCUSSION
    We are all either bullies, bullied or bystanders
    (Richard L. Gross, MD American Academy of Child and adolescent psychiatry, 2011)
    THE RESULTS
    Demographic characteristics
    Profile on the Bullied
    The Bystanders ~ similar to the bullied
    The Bullies
    Opinions on intimidation as a learning tool
    Opinions on the needs of policy to prevent
    intimidation
    DEMOGRAPHIC CHARACTERISTICS
    Of all 85 residents at Department Ob-gyn FMUI,
    76 (89%) participated in the study
    44.7% male and 55.3% female
    Range of age : mostly at 26-30 years, others 31-35 years
    Marital status:
    50% married, 48.3% single and 1.7% had divorced
    94.1% were from State University; 5.9% of Private
    University
    81.5% had urban and 18.5% had rural childhood
    PROFILE OF INTIMIDATION ON THE
    BULLIED / VICTIM PERSPECTIVE
    Yes
    51.3%
    No
    48.8%
    Being intimidated
    PROFILE ON THE BULLIED / VICTIM
    Once a month
    66.7%
    Less than once a month 16.7%
    Once a week 13.9%
    Every day 2.8%
    PROFILE ON THE BULLIED / VICTIM
    TYPE of intimidation
    Words (70%), written (17.1%), gesture (17.1%)
    Physical (23%), cyber-bullying (2.4%)
    BULLIERS
    Peer-residents (80.5%), Consultant s(46.3%)
    Nurses (14.6%), Patients (12.2%)
    IMPACT
    Wasted time (85.9%), financial problem (34.1%)
    No effect (28.8%), Health (14.9%)
    Family (7.3%), study program (2.4%)


    PROFILE ON THE BULLIED / VICTIM
    How to deal with the stress:
    Talk to others (39,0%)
    Wish the situation would go away(36.6%)
    Praying more (29.3%), positive thinking (24.4%)
    Doing nothing (14.6%). more sleep (12.2%),
    Eating more (9.8%), eating less(4.9%)
    Smoking (4.9%)
    Adequate supporters
    Colleague (95.8%), others (24.4%), no one (9.8%),
    Chief resident (12.2%), Head of Study Program(2.4%)
    PROFILE OF INTIMIDATION ON THE
    BULLIER PERSPECTIVE
    No
    91.7%
    Yes
    8.3%
    PROFILE OF INTIMIDATION ON THE
    BULLIER PERSPECTIVE
    Less than
    once a month
    50%
    At least once
    a month
    50%
    PROFILE OF INTIMIDATION ON THE
    BULLIER PERSPECTIVE
    Profile of Bullier vs. Bullied
    BEING INTIMIDATED
    Bullied Not Bullied
    INTIMIDATING

    Bullier

    100.0%


    Non-Bullier

    45.5%

    54.5%
    INTIMIDATION AS A LEARNING TOOL
    Will you do intimidation
    in the future?
    93.0% NO

    If intimidation continues
    Disagree 58.2%
    Try other specialty 11%
    NO
    60.9%
    YES
    13.0%
    YES/NO
    26.1%
    THE NEED OF POLICY
    Policy Maker
    Head of Department - 47.7%
    Head of Study Program - 35.4%
    Dean - 18.5%
    Head of University - 15.4%
    Chief Resident - 12.3%
    Minister of Health - 3.1%

    Includes: Rewards and punishment
    75% agree to punish bullier
    94.0% disagree giving reward to
    bullier

    Necessary
    81.2%
    Unnecessary
    18.8%
    DISCUSSION
    The survey has good response rate 89%
    Cohen 51% response rate
    Incidence of intimidation 50%
    Similar to other studies
    Ahmer 52%, medical students in Pakistan
    Frank 40%, medical students in US
    Scot 50%, junior residents in Auckland Hospital, New Zealand
    Mostly who had been intimidated were male, had rural
    childhood similar to study by Ahmer in Pakistan
    No sexual harassment has been revealed

    DISCUSSION
    The majority of bullier were peer-residents and
    consultant instead of being role-model
    Similar to Ahmer and Frank
    All of the bullier had prior experience of been
    bullied (100%) indicating transgenerational legacy
    Mostly disagree that intimidation is a learning tool
    It is different from findings in Musselman study that
    indicate the acceptable good intimidation
    Different acceptance is affected by different assumption,
    life background and interpretation
    Further studies are necessary

    DISCUSSION
    If intimidation continues, 11.9% would consider to
    quit and try other specialty
    Frank 13% for other profession; Cohen - 14% for
    other specialty and 22% for other profession
    Policy to prevent intimidation was regarded as
    necessary
    BMA - Integrated in Strategic Health Care Alliance
    National bullying hotline
    Head of Department would be the best policy
    maker (47.7%) and the least popular was Minister
    of Health (3.1%)
    CONCLUSION
    Intimidation, harassment and bullying have similar
    meaning to threat, to harm weaker person
    Role of intimidation as learning tool in medical
    education is still on debate.
    Good intimidation is simply called SUPERVISION
    CONCLUSION
    Our survey indicates high incidence of intimidation
    and bad impacts in Obs-gyn residents at
    Department of Obstetri and Ginekologi FMUI
    Cipto Mangunkusumo hospital
    Policy to prevent intimidation is necessary
    Intimidation is a cycle; therefore it should be
    managed by multi-disciplinary experts

    Those who can do; but those who cant bully
    (Tim Field, British Anti-bullying Activist, 1952)

    A man who is intimate with God is not intimidated by man
    (Leonard Ravenhill, Christian Evangelist, Author, 1907-1994)



    FIGHT BULLYING AND INTIMIDATION
    BREAK YOUR FEAR
    Once upon a time, there was a Korean Slave, who
    did not dare to free herself
    Even when a hero has come to set her free
    The hero told her,
    Youll be a SLAVE forever if you always think you are.
    Freedom is earned, not given and it starts when youre
    WILLING to free yourself
    The words inspired her, her will had set her free
    and
    made her have a peaceful life
    THANK YOU

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