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August 5, 2019

Walking on Eggshells With Trainees in the Clinical Learning Environment—Avoiding the Eggshells Is Not the Answer

Author Affiliations
  • 1Vagelos College of Physicians and Surgeons, Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
  • 2Mailman School of Public Health, Heilbrunn Department of Population & Family Health, Columbia University Medical Center, New York, New York
  • 3Vagelos College of Physicians and Surgeons, Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
JAMA Pediatr. 2019;173(10):907-908. doi:10.1001/jamapediatrics.2019.2501

Per the Cambridge Dictionary, walking on eggshells is defined as “being very careful not to offend someone or do anything wrong.”1 The implication is that one needs to tread carefully so as to not break the eggshells. Historically, medical faculty taught trainees in a culture in which there was a clear hierarchy and imbalance of power. Unfortunately, trainees continue to experience harassment and discrimination at significant rates.2 This has led to an increased awareness of the importance of being sensitive to the trainees’ needs, considering cultural differences, and managing unconscious biases. The current attention to preparing faculty to create safe spaces in which trainees can learn and grow3,4 is critical and laudable. However, this does not mean that the trainee will not experience discomfort or anxiety or feel challenged within the clinical learning environment.

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