Between two worlds - Medical student perceptions of humor and slang in thehospital setting

OBJECTIVE. Residents frequently use humor and slang at the expense of patie nts on the clinical wards. We studied how medical students react to and int erpret the "appropriateness" of derogatory and cynical humor and slang in a clinical setting. DESIGN. Semistructured, in-depth interviews. SETTING. Informal meeting spaces. PARTICIPANTS. Thirty-three medical students. MEASUREMENTS: Qualitative content analysis of interview transcriptions. MAIN RESULTS: Students' descriptions of the humorous stories and their resp onses reveal that students are able to take the perspective of both outside rs and insiders in the medical culture. Students' responses to these storie s show that they can identify the outsider's perspective both by seeing the mselves in the outsider's role and by identifying with patients. Students c an also see the insider's perspective, in that they identify with residents ' frustrations and disappointments and therefore try to explain why residen ts use this kind of humor. Their participation in the humor and slang-often with reservations-further reveals their ability to identify with the persp ective of an insider. CONCLUSIONS: Medical students describe a number of conflicting reactions to hospital humor that may enhance and exacerbate tensions that are already a n inevitable part of training for many students. This phenomenon requires g reater attention by medical educators.