Medical training focuses heavily on clinical skills but lacks in training for navigating challenging clinical scenarios especially with regard to diversity issues. Our objective was to assess third-year medical students’ preparedness to navigate such scenarios. A 24-item survey was administered electronically to third-year medical students describing a range of specific interactions with patients, peers, and “upper-levels” or superiors including residents and attendings, spanning subjects including gender, race/ethnicity, politics, age, sexual orientation/identity, disability, and religion. Students rated their level of comfort via a 5-point Likert scale ranging from 1 (“Very Uncomfortable”) to 5 (“Very Comfortable”). Basic demographics were collected and data were summarized for trends. Data were analyzed from 120 students (67% response rate, 54.2% female, 60.8% non-Hispanic white). Students reported lower comfort with peer and superiors compared to patient interactions (p < 0.0001). Students reported the highest comfort with sexual orientation/identity- and religion-related interactions (median (IQR): 3.3 (1.3) and 3.4 (10.0), respectively) and the lowest comfort with gender-, race/ethnicity-, and disability- related interactions (median (IQR): 2.3 (1.3), 2.0 (1.0), 2.5 (1.5), respectively). Males reported significantly higher median comfort levels for scenarios with upper-level, gender, and religion related interactions. Males were more likely to be completely comfortable versus females across the 24 scenarios, although multiple male response patterns showed evidence of a bimodal distribution. Third-year medical students report generally inadequate comfort with navigating complex clinical scenarios, particularly with peers and supervisors and relating to gender-, race/ethnicity-, and disability-specific conflicts. There are differences across gender with regards to median comfort and distribution of scores suggesting that there is a subgroup of males report high/very high comfort with challenging clinical scenarios. Students may benefit from enhanced training modules and personalized toolkits for navigating these scenarios.

中文翻译：

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评估三年级医学生与患者，同伴和主管一起应对挑战性临床情况的舒适性和准备情况

医学培训主要侧重于临床技能，但缺乏在具有挑战性的临床场景中导航的培训，尤其是在多样性问题方面。我们的目标是评估三年级医学生应对这种情况的准备情况。对三年级医学生进行了电子化的24项调查，描述了与患者，同龄人和“上级”或上级（包括居民和参加者）的一系列特定互动，涉及的主题包括性别，种族/民族，政治，年龄，性取向/身份，残疾和宗教信仰。学生通过从1（“非常不舒适”）到5（“非常舒适”）的5点李克特量表对他们的舒适度进行评分。收集了基本的人口统计资料，并汇总了趋势数据。分析了120名学生的数据（67％的回应率，54。女性2％，非西班牙裔白人60.8％）。与患者的互动相比，学生报告说同伴和上级的舒适度较低（p <0.0001）。学生报告说，与性取向/身份/宗教相关的互动最舒适（中位数（IQR）：3.3（1.3）和3.4（10.0）），而对性别，种族/民族和残障-的舒适度最低。相关互动（中位数（IQR）：分别为2.3（1.3），2.0（1.0），2.5（1.5））。对于与高层，性别和宗教相关的互动，男性报告的中位舒适度水平显着更高。在24种情况下，男性比女性更可能完全自在，尽管多种男性反应模式显示出双峰分布的迹象。三年级的医学生报告说，他们通常无法适应复杂的临床情况，尤其是与同龄人和上司打交道，并且与性别，种族/民族和残疾相关的冲突有关。在中位舒适度和分数分布方面，性别存在差异，这表明有一小组男性报告了极高/非常高的舒适度以及具有挑战性的临床情景。学生可能会受益于增强的培训模块和个性化工具包，以浏览这些情况。在中位舒适度和分数分布方面，性别存在差异，这表明有一小组男性报告了极高/非常高的舒适度以及具有挑战性的临床情景。学生可能会受益于增强的培训模块和个性化工具包，以浏览这些情况。在中位舒适度和分数分布方面，性别存在差异，这表明有一小组男性报告了极高/非常高的舒适度以及具有挑战性的临床情景。学生可能会受益于增强的培训模块和个性化工具包，以浏览这些情况。