Prevalence of Discrimination, Abuse, and Harassment in Emergency Medicine Residency Training in the US
The prevalence of workplace mistreatment and its association with the well-being of emergency medicine (EM) residents is unclear. More information about the sources of mistreatment might encourage residency leadership to develop and implement more effective strategies to improve professional well-be...
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| creator | Lall, Michelle D Bilimoria, Karl Y Lu, Dave W Zhan, Tiannan Barton, Melissa A Hu, Yue-Yung Beeson, Michael S Adams, James G Nelson, Lewis S Baren, Jill M |
| description | The prevalence of workplace mistreatment and its association with the well-being of emergency medicine (EM) residents is unclear. More information about the sources of mistreatment might encourage residency leadership to develop and implement more effective strategies to improve professional well-being not only during residency but also throughout the physician's career.
To examine the prevalence, types, and sources of perceived workplace mistreatment during training among EM residents in the US and the association between mistreatment and suicidal ideation.
In this survey study conducted from February 25 to 29, 2020, all residents enrolled in EM residencies accredited by the Accreditation Council for Graduate Medical Education (ACGME) who participated in the 2020 American Board of Emergency Medicine computer-based In-training Examination were invited to participate. A multiple-choice, 35-item survey was administered after the examination asking residents to self-report the frequency, sources, and types of mistreatment experienced during residency training and whether they had suicidal thoughts.
The types and frequency of workplace mistreatment and the sources of the mistreatment were identified, and rates of self-reported suicidality were obtained. Multivariable logistic regression models were used to examine resident and program characteristics associated with suicidal thoughts.
Of 8162 eligible EM residents, 7680 (94.1%) responded to at least 1 question on the survey; 6503 (79.7%) completed the survey in its entirety. A total of 243 ACGME-accredited residency programs participated, and 1 did not. The study cohort included 4768 male residents (62.1%), 2698 female residents (35.1%), 4919 non-Hispanic White residents (64.0%), 2620 residents from other racial/ethnic groups (Alaska Native, American Indian, Asian or Pacific Islander, African American, Mexican American, Native Hawaiian, Puerto Rican, other Hispanic, or mixed or other race) (34.1%), 483 residents who identified as lesbian, gay, bisexual, transgender, queer, or other (LGBTQ+) (6.3%), and 5951 residents who were married or in a relationship (77.5%). Of the total participants, 3463 (45.1%) reported exposure to some type of workplace mistreatment (eg, discrimination, abuse, or harassment) during the most recent academic year. A frequent source of mistreatment was identified as patients and/or patients' families; 1234 respondents (58.7%) reported gender discrimination, 867 (67.5%) racial discriminat |
| doi_str_mv | 10.1001/jamanetworkopen.2021.21706 |
| format | Article |
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To examine the prevalence, types, and sources of perceived workplace mistreatment during training among EM residents in the US and the association between mistreatment and suicidal ideation.
In this survey study conducted from February 25 to 29, 2020, all residents enrolled in EM residencies accredited by the Accreditation Council for Graduate Medical Education (ACGME) who participated in the 2020 American Board of Emergency Medicine computer-based In-training Examination were invited to participate. A multiple-choice, 35-item survey was administered after the examination asking residents to self-report the frequency, sources, and types of mistreatment experienced during residency training and whether they had suicidal thoughts.
The types and frequency of workplace mistreatment and the sources of the mistreatment were identified, and rates of self-reported suicidality were obtained. Multivariable logistic regression models were used to examine resident and program characteristics associated with suicidal thoughts.
Of 8162 eligible EM residents, 7680 (94.1%) responded to at least 1 question on the survey; 6503 (79.7%) completed the survey in its entirety. A total of 243 ACGME-accredited residency programs participated, and 1 did not. The study cohort included 4768 male residents (62.1%), 2698 female residents (35.1%), 4919 non-Hispanic White residents (64.0%), 2620 residents from other racial/ethnic groups (Alaska Native, American Indian, Asian or Pacific Islander, African American, Mexican American, Native Hawaiian, Puerto Rican, other Hispanic, or mixed or other race) (34.1%), 483 residents who identified as lesbian, gay, bisexual, transgender, queer, or other (LGBTQ+) (6.3%), and 5951 residents who were married or in a relationship (77.5%). Of the total participants, 3463 (45.1%) reported exposure to some type of workplace mistreatment (eg, discrimination, abuse, or harassment) during the most recent academic year. A frequent source of mistreatment was identified as patients and/or patients' families; 1234 respondents (58.7%) reported gender discrimination, 867 (67.5%) racial discrimination, 282 (85.2%) physical abuse, and 723 (69.1%) sexual harassment from patients and/or family members. Suicidal thoughts occurring during the past year were reported by 178 residents (2.5%), with similar prevalence by gender (108 men [2.4%]; 59 women [2.4%]) and race/ethnicity (113 non-Hispanic White residents [2.4%]; 65 residents from other racial/ethnic groups [2.7%]).
In this survey study, EM residents reported that workplace mistreatment occurred frequently. The findings suggest common sources of mistreatment for which educational interventions may be developed to help ensure resident wellness and career satisfaction.</description><identifier>ISSN: 2574-3805</identifier><identifier>EISSN: 2574-3805</identifier><identifier>DOI: 10.1001/jamanetworkopen.2021.21706</identifier><identifier>PMID: 34410392</identifier><language>eng</language><publisher>United States: American Medical Association</publisher><subject><![CDATA[Adult ; Cohort Studies ; Emergency medical care ; Emergency Medicine - statistics & numerical data ; Female ; Health Personnel - psychology ; Health Personnel - statistics & numerical data ; Hispanic people ; Humans ; Internship and Residency - statistics & numerical data ; Male ; Medical Education ; Minority & ethnic groups ; Multiple choice ; Occupational Stress - epidemiology ; Occupational Stress - psychology ; Online Only ; Original Investigation ; Prevalence ; Race ; Racism - psychology ; Racism - statistics & numerical data ; Sex discrimination ; Sexism - psychology ; Sexism - statistics & numerical data ; Sexual Harassment - psychology ; Sexual Harassment - statistics & numerical data ; Suicides & suicide attempts ; Surveys and Questionnaires ; United States - epidemiology ; Young Adult]]></subject><ispartof>JAMA network open, 2021-08, Vol.4 (8), p.e2121706-e2121706</ispartof><rights>2021. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright 2021 Lall MD et al. .</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a473t-cc2b3e77c0b3b801fe047c6e558c40c72aca420e5a546622fd2928c2c36dad6e3</citedby><cites>FETCH-LOGICAL-a473t-cc2b3e77c0b3b801fe047c6e558c40c72aca420e5a546622fd2928c2c36dad6e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,860,881,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34410392$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lall, Michelle D</creatorcontrib><creatorcontrib>Bilimoria, Karl Y</creatorcontrib><creatorcontrib>Lu, Dave W</creatorcontrib><creatorcontrib>Zhan, Tiannan</creatorcontrib><creatorcontrib>Barton, Melissa A</creatorcontrib><creatorcontrib>Hu, Yue-Yung</creatorcontrib><creatorcontrib>Beeson, Michael S</creatorcontrib><creatorcontrib>Adams, James G</creatorcontrib><creatorcontrib>Nelson, Lewis S</creatorcontrib><creatorcontrib>Baren, Jill M</creatorcontrib><title>Prevalence of Discrimination, Abuse, and Harassment in Emergency Medicine Residency Training in the US</title><title>JAMA network open</title><addtitle>JAMA Netw Open</addtitle><description>The prevalence of workplace mistreatment and its association with the well-being of emergency medicine (EM) residents is unclear. More information about the sources of mistreatment might encourage residency leadership to develop and implement more effective strategies to improve professional well-being not only during residency but also throughout the physician's career.
To examine the prevalence, types, and sources of perceived workplace mistreatment during training among EM residents in the US and the association between mistreatment and suicidal ideation.
In this survey study conducted from February 25 to 29, 2020, all residents enrolled in EM residencies accredited by the Accreditation Council for Graduate Medical Education (ACGME) who participated in the 2020 American Board of Emergency Medicine computer-based In-training Examination were invited to participate. A multiple-choice, 35-item survey was administered after the examination asking residents to self-report the frequency, sources, and types of mistreatment experienced during residency training and whether they had suicidal thoughts.
The types and frequency of workplace mistreatment and the sources of the mistreatment were identified, and rates of self-reported suicidality were obtained. Multivariable logistic regression models were used to examine resident and program characteristics associated with suicidal thoughts.
Of 8162 eligible EM residents, 7680 (94.1%) responded to at least 1 question on the survey; 6503 (79.7%) completed the survey in its entirety. A total of 243 ACGME-accredited residency programs participated, and 1 did not. The study cohort included 4768 male residents (62.1%), 2698 female residents (35.1%), 4919 non-Hispanic White residents (64.0%), 2620 residents from other racial/ethnic groups (Alaska Native, American Indian, Asian or Pacific Islander, African American, Mexican American, Native Hawaiian, Puerto Rican, other Hispanic, or mixed or other race) (34.1%), 483 residents who identified as lesbian, gay, bisexual, transgender, queer, or other (LGBTQ+) (6.3%), and 5951 residents who were married or in a relationship (77.5%). Of the total participants, 3463 (45.1%) reported exposure to some type of workplace mistreatment (eg, discrimination, abuse, or harassment) during the most recent academic year. A frequent source of mistreatment was identified as patients and/or patients' families; 1234 respondents (58.7%) reported gender discrimination, 867 (67.5%) racial discrimination, 282 (85.2%) physical abuse, and 723 (69.1%) sexual harassment from patients and/or family members. Suicidal thoughts occurring during the past year were reported by 178 residents (2.5%), with similar prevalence by gender (108 men [2.4%]; 59 women [2.4%]) and race/ethnicity (113 non-Hispanic White residents [2.4%]; 65 residents from other racial/ethnic groups [2.7%]).
In this survey study, EM residents reported that workplace mistreatment occurred frequently. The findings suggest common sources of mistreatment for which educational interventions may be developed to help ensure resident wellness and career satisfaction.</description><subject>Adult</subject><subject>Cohort Studies</subject><subject>Emergency medical care</subject><subject>Emergency Medicine - statistics & numerical data</subject><subject>Female</subject><subject>Health Personnel - psychology</subject><subject>Health Personnel - statistics & numerical data</subject><subject>Hispanic people</subject><subject>Humans</subject><subject>Internship and Residency - statistics & numerical data</subject><subject>Male</subject><subject>Medical Education</subject><subject>Minority & ethnic groups</subject><subject>Multiple choice</subject><subject>Occupational Stress - epidemiology</subject><subject>Occupational Stress - psychology</subject><subject>Online Only</subject><subject>Original Investigation</subject><subject>Prevalence</subject><subject>Race</subject><subject>Racism - psychology</subject><subject>Racism - statistics & numerical data</subject><subject>Sex discrimination</subject><subject>Sexism - psychology</subject><subject>Sexism - statistics & numerical data</subject><subject>Sexual Harassment - psychology</subject><subject>Sexual Harassment - statistics & numerical data</subject><subject>Suicides & suicide attempts</subject><subject>Surveys and Questionnaires</subject><subject>United States - epidemiology</subject><subject>Young Adult</subject><issn>2574-3805</issn><issn>2574-3805</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkV9PFDEUxRsjEYJ8BdLoiw_sevtn2lkfTAiCmGA0As9Np3Nn6TrTLu0Mhm9PF5AAT23a37m55xxCPjCYMwD2eWUHG3D8F9PfuMYw58DZnDMN6g3Z4ZWWM1FD9fbZfZvs5bwCAA5MLFT1jmwLKRmIBd8h3e-EN7bH4JDGjn7z2SU_-GBHH8MBPWymjAfUhpae2mRzHjCM1Ad6PGBaFtUt_Ymtdz4g_YPZt_dPF8n64MNyA45XSC_P35OtzvYZ9x7PXXJ5cnxxdDo7-_X9x9Hh2cxKLcaZc7wRqLWDRjQ1sA5BaqewqmonwWlunZUcsLKVVIrzruULXjvuhGptq1Dskq8Pc9dTM2DryrbJ9mZdPNl0a6L15uVP8FdmGW9MLbSuFC8DPj0OSPF6wjyaoUSCfV9Cj1M2vEC1KGFCQT--QldxSqHYM1wpXYNkQhfqywPlUsw5Yfe0DAOzadS8atRsGjX3jRbx_nM7T9L__Yk7fxiisQ</recordid><startdate>20210802</startdate><enddate>20210802</enddate><creator>Lall, Michelle D</creator><creator>Bilimoria, Karl Y</creator><creator>Lu, Dave W</creator><creator>Zhan, Tiannan</creator><creator>Barton, Melissa A</creator><creator>Hu, Yue-Yung</creator><creator>Beeson, Michael S</creator><creator>Adams, James G</creator><creator>Nelson, Lewis S</creator><creator>Baren, Jill M</creator><general>American Medical Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210802</creationdate><title>Prevalence of Discrimination, Abuse, and Harassment in Emergency Medicine Residency Training in the US</title><author>Lall, Michelle D ; Bilimoria, Karl Y ; Lu, Dave W ; Zhan, Tiannan ; Barton, Melissa A ; Hu, Yue-Yung ; Beeson, Michael S ; Adams, James G ; Nelson, Lewis S ; Baren, Jill M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a473t-cc2b3e77c0b3b801fe047c6e558c40c72aca420e5a546622fd2928c2c36dad6e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Cohort Studies</topic><topic>Emergency medical care</topic><topic>Emergency Medicine - statistics & numerical data</topic><topic>Female</topic><topic>Health Personnel - psychology</topic><topic>Health Personnel - statistics & numerical data</topic><topic>Hispanic people</topic><topic>Humans</topic><topic>Internship and Residency - statistics & numerical data</topic><topic>Male</topic><topic>Medical Education</topic><topic>Minority & ethnic groups</topic><topic>Multiple choice</topic><topic>Occupational Stress - epidemiology</topic><topic>Occupational Stress - psychology</topic><topic>Online Only</topic><topic>Original Investigation</topic><topic>Prevalence</topic><topic>Race</topic><topic>Racism - psychology</topic><topic>Racism - statistics & numerical data</topic><topic>Sex discrimination</topic><topic>Sexism - psychology</topic><topic>Sexism - statistics & numerical data</topic><topic>Sexual Harassment - psychology</topic><topic>Sexual Harassment - statistics & numerical data</topic><topic>Suicides & suicide attempts</topic><topic>Surveys and Questionnaires</topic><topic>United States - epidemiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lall, Michelle D</creatorcontrib><creatorcontrib>Bilimoria, Karl Y</creatorcontrib><creatorcontrib>Lu, Dave W</creatorcontrib><creatorcontrib>Zhan, Tiannan</creatorcontrib><creatorcontrib>Barton, Melissa A</creatorcontrib><creatorcontrib>Hu, Yue-Yung</creatorcontrib><creatorcontrib>Beeson, Michael S</creatorcontrib><creatorcontrib>Adams, James G</creatorcontrib><creatorcontrib>Nelson, Lewis S</creatorcontrib><creatorcontrib>Baren, Jill M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>JAMA network open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lall, Michelle D</au><au>Bilimoria, Karl Y</au><au>Lu, Dave W</au><au>Zhan, Tiannan</au><au>Barton, Melissa A</au><au>Hu, Yue-Yung</au><au>Beeson, Michael S</au><au>Adams, James G</au><au>Nelson, Lewis S</au><au>Baren, Jill M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence of Discrimination, Abuse, and Harassment in Emergency Medicine Residency Training in the US</atitle><jtitle>JAMA network open</jtitle><addtitle>JAMA Netw Open</addtitle><date>2021-08-02</date><risdate>2021</risdate><volume>4</volume><issue>8</issue><spage>e2121706</spage><epage>e2121706</epage><pages>e2121706-e2121706</pages><issn>2574-3805</issn><eissn>2574-3805</eissn><abstract>The prevalence of workplace mistreatment and its association with the well-being of emergency medicine (EM) residents is unclear. More information about the sources of mistreatment might encourage residency leadership to develop and implement more effective strategies to improve professional well-being not only during residency but also throughout the physician's career.
To examine the prevalence, types, and sources of perceived workplace mistreatment during training among EM residents in the US and the association between mistreatment and suicidal ideation.
In this survey study conducted from February 25 to 29, 2020, all residents enrolled in EM residencies accredited by the Accreditation Council for Graduate Medical Education (ACGME) who participated in the 2020 American Board of Emergency Medicine computer-based In-training Examination were invited to participate. A multiple-choice, 35-item survey was administered after the examination asking residents to self-report the frequency, sources, and types of mistreatment experienced during residency training and whether they had suicidal thoughts.
The types and frequency of workplace mistreatment and the sources of the mistreatment were identified, and rates of self-reported suicidality were obtained. Multivariable logistic regression models were used to examine resident and program characteristics associated with suicidal thoughts.
Of 8162 eligible EM residents, 7680 (94.1%) responded to at least 1 question on the survey; 6503 (79.7%) completed the survey in its entirety. A total of 243 ACGME-accredited residency programs participated, and 1 did not. The study cohort included 4768 male residents (62.1%), 2698 female residents (35.1%), 4919 non-Hispanic White residents (64.0%), 2620 residents from other racial/ethnic groups (Alaska Native, American Indian, Asian or Pacific Islander, African American, Mexican American, Native Hawaiian, Puerto Rican, other Hispanic, or mixed or other race) (34.1%), 483 residents who identified as lesbian, gay, bisexual, transgender, queer, or other (LGBTQ+) (6.3%), and 5951 residents who were married or in a relationship (77.5%). Of the total participants, 3463 (45.1%) reported exposure to some type of workplace mistreatment (eg, discrimination, abuse, or harassment) during the most recent academic year. A frequent source of mistreatment was identified as patients and/or patients' families; 1234 respondents (58.7%) reported gender discrimination, 867 (67.5%) racial discrimination, 282 (85.2%) physical abuse, and 723 (69.1%) sexual harassment from patients and/or family members. Suicidal thoughts occurring during the past year were reported by 178 residents (2.5%), with similar prevalence by gender (108 men [2.4%]; 59 women [2.4%]) and race/ethnicity (113 non-Hispanic White residents [2.4%]; 65 residents from other racial/ethnic groups [2.7%]).
In this survey study, EM residents reported that workplace mistreatment occurred frequently. The findings suggest common sources of mistreatment for which educational interventions may be developed to help ensure resident wellness and career satisfaction.</abstract><cop>United States</cop><pub>American Medical Association</pub><pmid>34410392</pmid><doi>10.1001/jamanetworkopen.2021.21706</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adult Cohort Studies Emergency medical care Emergency Medicine - statistics & numerical data Female Health Personnel - psychology Health Personnel - statistics & numerical data Hispanic people Humans Internship and Residency - statistics & numerical data Male Medical Education Minority & ethnic groups Multiple choice Occupational Stress - epidemiology Occupational Stress - psychology Online Only Original Investigation Prevalence Race Racism - psychology Racism - statistics & numerical data Sex discrimination Sexism - psychology Sexism - statistics & numerical data Sexual Harassment - psychology Sexual Harassment - statistics & numerical data Suicides & suicide attempts Surveys and Questionnaires United States - epidemiology Young Adult |
| title | Prevalence of Discrimination, Abuse, and Harassment in Emergency Medicine Residency Training in the US |
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