Mapping the scientific research on the negative aspects of the medical school learning environment

Rodolfo F. Damiano, Andrey O. Da Cruz, José G. De Oliveira, Lisabeth F. DiLalla, Sean Tackett, Oscarina Da Silva Ezequiel, Giancarlo Lucchetti

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Objective: We sought to understand the landscape of published articles regarding medical schools' learning environments (LE) worldwide, with an explicit focus on potentially negative aspects of the LE as an effort to identify areas specifically in need of remediation or intervention that could prevent future unprofessional behaviours, burnout, violence and mistreatment among students and physicians. Methods: A bibliometric analysis was conducted in six electronic databases (PubMed/Medline, Web of Science, Cochrane Library, SCOPUS, ERIC-ProQuest and PsycINFO) through December 31, 2016, including 12 themes: Learning environment - general, hidden curriculum (negative), unethical behaviours, bullying/hazing, violence, sexual discrimination, homophobia, racism, social discrimination, minorities' discrimination, professional misconduct, and "other" negative aspects. Results: Of 9,338 articles found, 710 met the inclusion criteria. The most common themes were general LE (233 articles), unprofessional behaviours (91 articles), and sexual discrimination (80 articles). Approximately 80% of articles were published in the 21st century. Conclusion: There is a clear increase in scientific articles on negative aspects of the medical school LE in high-quality journals, especially in the 21st century. However, more studies are needed to investigate negative LE aspects with greater attention paid to experimental, longitudinal, and cross-cultural study designs.

Original languageEnglish (US)
Pages (from-to)1050-1057
Number of pages8
JournalRevista da Associacao Medica Brasileira
Issue number11
StatePublished - Nov 2018


  • Ethics
  • Learning Environment
  • Medical Education
  • Medical Students
  • Professionalism

ASJC Scopus subject areas

  • Medicine(all)


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