Wigg, Luisa, Chao, Marc, and Li, Wendy Wen (2025) Teaching by Humiliation in Australian Medical Students: Its Prevalence, Relationship with Mental Distress, and the Factors Underlying the Relationship. Medical Science Educator, 36. pp. 225-236.

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Abstract

Introduction: In medical education, teaching by humiliation (TBH) has been identified as a potentially harmful practice contributing to mental distress. However, this is under-researched in the Australian context. This study aims to investigate the prevalence of TBH and mental distress in Australian medical students. It will explore correlations between these variables, seeking to establish a mediation relationship. Methods: Data was collected through an online cross-sectional survey of Australian medical students, returning 244 responses. Using SPSS, crosstabulation was conducted to estimate the prevalence of TBH and mental distress. Spearman’s rho correlation tests were performed to determine associations between variables. Mediation analysis was conducted with TBH as the independent variable, mental distress as the dependent variable, and anger, shame, and embarrassment as mediators. Results: The majority (80.3%) of participants experienced TBH. There was a high prevalence of depression (57.8%), anxiety (54.1%), and stress (72.9%). A weak positive correlation was found between TBH, mental distress, and mediators. TBH did not have a direct effect on mental distress (c’ = 0.28 (95%Cl = -1.00, 1.55), p =.67). However, indirect effects through anger (a1b1 = 1.31 (95%Cl = 0.55, 2.27)), shame (a2b2 = 0.45 (95%Cl = 0.02, 0.99)), and embarrassment (a3b3 = 1.19 (95%Cl = 0.33, 2.18)) were significant. Conclusions: This study suggests that TBH is a systemic issue, indicating a significant prevalence of mental distress in Australian medical students. While experiencing anger, shame, or embarrassment from TBH was linked to mental distress, TBH itself did not have direct effects on mental health.

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