Major ArticleSickness presenteeism in clinical clerks: Negatively reinforced behavior or an issue of patient safety?

•Final year medical students were surveyed about illness during clinical rotations.•Of the students, 37% reported presenteeism while experiencing contagious symptoms.•Reasons for presenteeism in medical students may differ from other groups.•Medical educators need to consider presenteeism and its effect on patient safety.

BackgroundThe purpose of this study was to investigate sickness presenteeism in medical students and to understand the factors that may promote this behavior.MethodsAll 178 final year medical students (clinical clerks) at the University of Calgary, Class of 2014 were invited to complete an online, anonymous, cross-sectional survey. After completing each mandatory rotation, students were sent a link to the online survey. Students were asked to report days of illness and whether they attended clinical or educational activities while ill. Students were also asked about consequences of missed days and reasons for attending while ill.ResultsOut of a possible 1,068 surveys, 549 surveys were returned, reflecting a 51% response rate. Overall, 37.0% ± 11.8% of the respondents reported attending while experiencing symptoms suggestive of a contagious illness. Overall, the odds of presenteeism (ie, attending while ill/absent while ill) for all clerkship rotations were 4.92. The most frequent reasons (56%) were concerns regarding evaluation or the impact that missing time from the rotation would have on their learning.ConclusionsSickness presenteeism is common among medical students. Relevant factors may be different for students than other health care workers. Medical educators should be aware of these factors when developing policies to help promote professionalism and patient safety.