ABSTRACT
El maltrato, la amenaza, el acoso, la discriminación y la violencia de género en la educación médica son fenómenos generalizados mundialmente y altamente prevalentes. Los comportamientos inapropiados hacia los estudiantes de medicina han sido reconocidos como una amenaza pues interfieren en la construcción de la identidad profesional, el bienestar estudiantil y éxito académico contri-buyendo al agotamiento físico, el desgaste emocional, y el abuso de alcohol y otras sustancias psicoactivas. El impacto negativo de un ambiente jerárquico donde las relaciones de poder pueden tornarse abusivas cambia el enfoque empático y altruista que se espera de un profesional de la salud y perpetúa el maltrato por generaciones. En facultades de medicina de Latinoamérica, la prevalencia de conductas inapropiadas en estudiantes de pregrado y posgrado varía de 17 a 100%, con una importante participación de profesores y residentes como perpetradores del maltrato. Es responsabilidad de los líderes en educación médica enfocar sus esfuerzos pedagó-gicos en formar profesionales humanizados, empáticos y felices en modelos de enseñanza que promuevan la dignidad y los derechos de los estudiantes. La profesión médica debe asumir un papel de liderazgo condenando las conductas inapropiadas y aportando un enfoque de tolerancia cero para todas las formas de intimidación y acoso en el lugar de aprendizaje y de trabajo, así como fomentar la igualdad de oportunidades en la fuerza laboral médica.
Harassment, threatening behaviours, discrimination, and gender-based violence in medical education are global and widespread phe-nomena. Inappropriate behaviours towards medical students have been recognised as a threat to medical education. They interfere with the construction of professional identity, student well-being, and academic success, contributing to physical exhaustion, emotional burnout, and alcohol abuse. The negative impact of a hierarchical environment where abusive power-drive relationships can modify the empathic and altruistic approach expected from a health professional as perpetuates abuse for generations. In Latin American medical schools, the prevalence of inappropriate behaviour in undergraduate and graduate students ranges from 17 to 100%, with professors and residents as perpetrators of misconduct. Focus in medical schools must be based on training empathetic health professionals that embrace the rights of students and human dignity. The medical profession must take a leadership role in condemning inappropriate behaviour and bringing a zero-tolerance approach to all forms of bullying and harassment in hospitals and learning environments, as well as promoting equal opportunity in the medical workforce.
ABSTRACT
BACKGROUND: In Colombia, the use of alcohol is one of the main risky behaviors carried out by adolescents, given that alcohol is the principal drug of abuse in this age group. Understanding how adolescents learn about risk and behavior is important in developing effective prevention programs. The Theory of Social learning underlines the importance of social interaction in the learning process. It suggests that learning can occur in three ways: a live model in which a person is enacting the desired behavior, verbal instruction when the desired behavior is described, and symbolic learning in which modeling occurs by influence of the media. This study explores these three forms of learning in the perception of risk and behavior related to the use of alcohol in a group of students between 12 and 14 years of age in Bogotá, Colombia. MATERIALS AND METHODS: This is a qualitative research study, which is part of a larger study exploring the social representations of risk and alcohol use in adolescents and their communities. The sample group included 160 students from two middle schools (7th and 8th graders) in Bogotá, Colombia. Six sessions of participant observation, 12 semi-structured interviews, and 12 focus group discussions were conducted for data collection. Data were analyzed using the Atlas ti software (V7.0) (ATLAS.ti Scientific Software Development GmbH, London, UK), and categories of analysis were developed using a framework analysis approach. RESULTS: Adolescents can identify several risks related to the use of alcohol, which for the most part, appear to have been learned through verbal instruction. However, this risk recognition does not appear to correlate with their behavior. Parental modeling and messages conveyed by the media represent two other significant sources of learning that are constantly contradicting the messages relayed through verbal instruction and correlate to a greater extent with adolescent behavior. CONCLUSION: The three different forms of learning described by Social Learning Theory play a significant role in the construction of risk perception and behavior in adolescents. This underlines the necessity of consciously evaluating how examples set by adults as well as the ideas expressed by the media influence adolescents' attitudes and behavior, ensuring that these do not directly contradict and ultimately obliterate the messages we are constantly trying to convey to this age group.
