Teaching is what most doctors do during the period of their training or throughout their career as they encounter medical students or even patients. In fact, the origin of the word doctor, came from the word docere, which means “to teach”.
With regards to a post by Wids about teaching, I was prompt to think about other things that may happen in teaching. Regardless of the teaching and learning environment, in whatever context and level of education, bullying can happen; and the worse part is that the teacher can be the bully. Bullying by teacher happen at the lowest level of primary school education up to the university level.
I have no expertise in discussing the matter. However, I’d still like to point out some important resources about bullying by teachers.
WebMD gives an overview about teachers who bully in http://www.webmd.com/parenting/features/teachers-who-bully while another document by Allan McEvoy provides a more comprehensive information at the site ‘Stop Bullying Now’.
According to McEvoy,
bullying by teachers (or other staff, including coaches,
who have supervisory control over students) is defined as
a pattern of conduct, rooted in a power differential,
that threatens, harms, humiliates, induces fear, or
causes students substantial emotional distress.
Regarding the nature of bullying, the author stated the following:
it is an abuse of power that tends to be chronic
and often is expressed in a public manner.
It is a form of humiliation that generates attention
while it degrades a student in front of others.
In effect, the bullying can be a public degradation ceremony
in which the victim’s capabilities are debased
and his or her identity is ridiculed.
This explanation implies that regardless of the chosen method of bullying or intimidation, the effect on the students is what shows that certain behaviour of a teacher as an act of bullying.
Bullying is not a part of proper teaching.
Let me repeat this: bullying is not a part of proper teaching.
A set of references about bullying in medicine is provided by Wikipedia here. An anonymous site even regularly posts about academic bullying.
Professional attention bring light to the matter. The British Medical Association (BMA) has a complete guidance for medical students on harassment, intimidation and bullying which aims to provide help when students face bullying by peers or teachers. The British Medical Journal (BMJ) published an article by Tim Field entitled “Those who can, do; those who can’t bully”.
Teaching and learning, as any other aspect of culture, can vary between different settings and countries. Most of the time, in a culture where hierarchy is rigidly maintained, students have to accept bullying without ever having the chance to fight it, or even to consider that they shouldn’t accept such treatment by their teacher. Most will never even realize that they are victims of bullying which may lead them to think that intimidation and humiliation is an acceptable form of teaching and academic life. Well, they are not: bullying is not a part of proper teaching.
The act of bullying can be continuously practiced freely in academics, and so many are unaware that they themselves are part of the problem. In university, even, there are situations that keep alive the vicious cycle of bullying: when there is no knowledge by the staff and students about bullying; when there is no stance against bullying; when acts of bullying are culturally accepted as normal; when acts of bullying are considered as a part of a teacher’s personality and habit instead of abusive behavior towards students; when acts of bullying are considered as part of educating and teaching professionally; when as a teacher you see fellow teacher who bully students but do nothing to stop it; when the students themselves, not being able to fight back anyway, refuse to see intimidation and verbal abuse as form of bullying by teacher.
Perhaps the first step to prevent bullying by teachers is to be willing to admit that there are teachers who bully their students. Perhaps the first step is to understand that students should not accept the unacceptable behaviour of their teachers towards them: students have to be aware that as long as they respect teachers, they also deserve respect from their teachers.
When this is a matter involving power differential, as stated by McEvoy, then students generally will not have the power, authority nor capacity to fight back on their own. The BMA in United Kingdom for example, has acknowledged the issue of bullying in medical teaching, and has a list of counselors and help line that students can contact to seek help when they experience bullying.
Unfortunately, such help is an unobtainable privilege for most students in other countries. The act of bullying is dismissively considered “normal” and “educative”. The perpetrator keep doing it, and the students are intimidated to accept it.
I will end this by asking some questions I don’t have answers to. To what extent can we apply a universal definition of bullying? Does culture play a prominent role in determining whether a teacher’s actions (and verbal statements) are a form of bullying students? Are certain actions and words by teachers seen as bullying by a certain culture (or country), while being perceived as a normal thing by (students and teachers of) other cultures/countries? To what extent students have the right to be respected by the teachers, and to what extent the teachers acknowledge their obligation to respect students?
But one thing we should know. Bullying is not a part of proper teaching.
23 June 2011.
Filed under: Uncategorized, medical education, medical students and residents, popular
Dokter Blog: from the desk of Rahajeng Tunjungputri 
March 8, 2011 • 12:58 am 0
Commentary: Professor Robot, psychiatrists, and overdosing CT-scans
I will add interesting news I stumble upon this week, and write short commentaries and thoughts about them. The original links to the news are available and I make no attempts to summarize these news.
Professor Robot
Kevin Warwick, a professor of cybernetics at the University of Reading, has a silicon chip implanted into his forearm to fire electrical impulses back to the brain and observe whether human could interpret and respond to stimulus sent by computers. The success of this self-experiment may be revolutionary for development of prosthesis. He basically has turned himself into bionic human purely for the sake of research.
By Jim Naughten for TIME. Image from http://www.time.com/time/photogallery/0,29307,2051431_2238088,00.html
If that sounds fascinating, try other examples of self-experimenting scientists in the article: Stubbins Ffirth drank the blackened vomit of yellow-fever patients in his attempts to prove that the disease was not an infectious one, while James Caroll and Jesse Lazear, US army physicians expose themselves to mosquito bites to prove that these vectors are transmitting the disease. Caroll had long-term complications and Lazear died during the course of this experiment.
These scientists have been regarded as either altruist or extremists. While it’s interesting what this may lead to discover, most research in the world of course are based on strict research protocol and recruit volunteers which safety are ensured.
Psychiatrists
This week, G. Harris on The New York Times brought us the story of how psychiatry is a transformed field. Psychiatrists, due to what they say a systemic shift in psychiatry care provision -that is payment by insurance companies-, now are “forced” to “talk less and prescribe more”. They no longer have the time for talk therapy and instead opt to examine and treat patients with high efficiency. This include only asking close ended questions relevant to their chief complaints, and prescribing drugs to allow them to function. The words “quality of life of patients” was not once mentioned in the article.
While this is perhaps the first time there is such exposure on the profession in US, I have sensed it since a few years ago, and this perhaps is already true for other fields of medicine in a country where doctors are paid on an out-of-pocket basis like Indonesia. You can’t afford a 45-minutes appointments when there are no appointments system, and you’re paid exactly the amount of money no matter how much time you spent on a patient. It’s still however, very much different from the practice of medicine in a well-insured country like The Netherlands for example, where it is mandatory to schedule your doctors appointments, and have longer appointments time for new patients and a fixed minimum time for every following appointments.
Image is not mine, from http://www.cartoonstock.com/directory/p/psychiatrist.asp
The article was closed on the note that a physician said, “I’m concerned that I may be put in a position where I’d be forced to sacrifice patient care to make a living, and I’m hoping to avoid that.”. But that is not the truth. The truth is that they are already in that position, and they know it, and it’s not just to make a living, it’s to make up the lifestyle that they want.
Click here for the original story
Overdosing CT-Scans
Cabell Huntington Hospital in Huntington, West Virginia are under scrutiny after they were found to perform CT-scan with radiation dose of 10x the necessary dose. This result in serious and dangerous medical side effects for patients as a result of over-radiation. The hospital was not responding adequately to this serious events, while the manufacturer of the CT-scan have filed a report to the FDA that this error was caused by medical technician who had manually increased the radiation to obtain sharper image, which was not necessary to detect pathology on the scans.
Image from http://www.worldculturepictorial.com/blog/content/ct-scan-study-shows-increased-radiation-exposure-cancer-risks-tests-often-unnecessary
I can imagine that this events are not being regularly monitored in many parts of the world, and patient safety are relatively neglected. It’s time that we bring more awareness on this matter.
Click here for the original story
Rahajeng. Nijmegen, 7 March 2011
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Filed under: Uncategorized, bioethics, biotechnology, Commentary, doctoring, imaging, infectious disease