Get Over It: Surgical Residents’ Responses to Simulated Harassment. A Multi Method Study

IF 2.6 3区医学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Surgical Education Pub Date : 2025-01-15 DOI:10.1016/j.jsurg.2024.103397

Myriam Johnson , Byunghoon (Tony) Ahn , Keerat Grewal , Negar Matin , Jean-Sébastien Pelletier , Liane S. Feldman , Gerald M. Fried , Melina Tsiolis , Jason M. Harley

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引用次数: 0

Abstract

OBJECTIVE

This study examined the response strategies of Surgery residents as bystanders to harassment in a simulated clinical environment, their alignment with the bystander intervention model, and the motivations behind their actions.

DESIGN

Participants watched an educational video on harassment and ways to address it prior to undergoing a simulated clinical scenario where they witnessed a senior resident harassing a medical student. The study used audio-video recordings of the simulations to capture and analyze residents' verbal and nonverbal responses to harassment. Frequencies from deductive thematic analysis were used for descriptive analysis, and nonparametric chi-square tests. Audio recordings of debriefings following simulations were also analyzed using deductive thematic analysis to explore residents’ motivations behind their responses.

SETTING

The study was conducted in a controlled environment at McGill University's Steinberg Centre for Simulation and Interactive Learning (Montreal, Canada).

PARTICIPANTS

Participants included 32 Surgery residents completing the simulation as part of their Objective Structured Clinical Examinations. 28 residents provided usable data for analysis.

RESULTS

Residents used passive responses significantly more frequently than other responses throughout the simulation, especially in reaction to harassment. Analysis revealed that residents often delayed intervention, opting to remain passive or reassuring the victim rather than confronting the harasser. Debriefing showed that some residents intervened to denounce the SR's behavior or support the MS, while others hesitated due to discomfort with power dynamics, fear of repercussions, or uncertainty about addressing the situation

CONCLUSIONS

The study found that Surgery residents exhibit a tendency towards passive bystander responses in the face of harassment highlighting the need for targeted educational strategies to address power dynamics, build confidence in bystander intervention, and promote proactive responses to harassment in clinical training. Future research should explore similar dynamics across different medical professionals and consider intersectional factors to enhance antiharassment initiatives in medical education.

查看原文本刊更多论文

克服它：外科住院医生对模拟骚扰的反应。多方法研究。

目的：本研究考察了外科住院医生作为旁观者在模拟临床环境中对骚扰的反应策略、他们与旁观者干预模型的一致性以及他们行为背后的动机。设计：参与者观看了一段关于骚扰和解决方法的教育视频，然后经历了一个模拟的临床场景，他们目睹了一名高级住院医生骚扰一名医科学生。该研究使用模拟的音频和视频记录来捕捉和分析居民对骚扰的口头和非口头反应。来自演绎主题分析的频率用于描述性分析和非参数卡方检验。运用演绎主题分析，对模拟后的述职录音进行分析，探讨居民回答背后的动机。环境：这项研究是在麦吉尔大学斯坦伯格模拟和互动学习中心（加拿大蒙特利尔）的一个受控环境中进行的。参与者：参与者包括32名外科住院医生，他们完成了模拟，作为他们客观结构化临床检查的一部分。28名住院医生提供了可用的数据用于分析。结果：在整个模拟过程中，居民使用被动反应的频率明显高于其他反应，特别是在对骚扰的反应中。分析显示，居民往往延迟干预，选择保持被动或安抚受害者，而不是面对骚扰者。汇报显示，一些居民介入，谴责SR的行为或支持MS，而另一些人则由于对权力动态的不适、害怕后果或不确定如何处理这种情况而犹豫不决。研究发现，外科住院医生在面对骚扰时表现出被动的旁观者反应的倾向，这突出了有针对性的教育策略的必要性，以解决权力动力学问题，建立旁观者干预的信心，并在临床培训中促进对骚扰的主动反应。未来的研究应该探索不同医学专业人员之间的类似动态，并考虑交叉因素，以加强医学教育中的反骚扰举措。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Surgical Education EDUCATION, SCIENTIFIC DISCIPLINES-SURGERY

CiteScore

5.60

自引率

10.30%

发文量

261

审稿时长

48 days

期刊介绍： The Journal of Surgical Education (JSE) is dedicated to advancing the field of surgical education through original research. The journal publishes research articles in all surgical disciplines on topics relative to the education of surgical students, residents, and fellows, as well as practicing surgeons. Our readers look to JSE for timely, innovative research findings from the international surgical education community. As the official journal of the Association of Program Directors in Surgery (APDS), JSE publishes the proceedings of the annual APDS meeting held during Surgery Education Week.