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Sahiti Q, Shearer C, Thomson C, Sutherland L, Bowes D. Addressing medical resident mistreatment: A resident-centred approach. MEDICAL TEACHER 2024; 46:769-775. [PMID: 37972586 DOI: 10.1080/0142159x.2023.2279903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
INTRODUCTION Mistreatment negatively impacts the wellbeing of medical learners and is related to worse patient outcomes and team functioning. Resident perspectives on improving mistreatment reporting structures and investigations have not been explored. We aimed to understand residents' views on safe reporting structures, investigations, and resolution processes. METHOD We conducted an exploratory sequential mixed method study beginning with a series of qualitative interviews to inform an anonymous online survey to all Dalhousie University residents (N = 645). RESULTS When interviewed, residents (N = 10) discussed personal experiences with mistreatment, barriers to reporting, and how these processes could better serve them. Themes from the interviews were imbedded in an anonymous online survey to explore their prevalence among a larger group. Residents (N = 120; 19%) completed the online survey and revealed that mistreatment was very common yet underreported. Barriers to reporting included confidentiality concerns, perceptions that reporting would not change anything, and fear of retaliation. Desired outcomes for perpetrators depended on the perpetrator's position and incident severity, and most prefer a remedial approach. CONCLUSION Resident mistreatment remains prevalent and current processes of dealing with reports may be inadequate. Residents have thoughtful insights for improving institutional policies and procedures and should be meaningfully engaged.
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Affiliation(s)
| | - Cindy Shearer
- Faculty of Medicine, Dalhousie University, Halifax, Canada
- Faculty of Medicine, Department of Postgraduate Medical Education, Dalhousie University, Halifax, Canada
| | - Carolyn Thomson
- Faculty of Medicine, Dalhousie University, Halifax, Canada
- Faculty of Medicine, Department of Postgraduate Medical Education, Dalhousie University, Halifax, Canada
- Faculty of Medicine, Department of Family Medicine, Dalhousie University, Halifax, Canada
- Faculty of Medicine, Office of Resident Affairs, Dalhousie University, Halifax, Canada
| | - Lisa Sutherland
- Faculty of Medicine, Dalhousie University, Halifax, Canada
- Faculty of Medicine, Office of Resident Affairs, Dalhousie University, Halifax, Canada
| | - David Bowes
- Faculty of Medicine, Dalhousie University, Halifax, Canada
- Faculty of Medicine, Department of Postgraduate Medical Education, Dalhousie University, Halifax, Canada
- Faculty of Medicine, Department of Radiation Oncology, Dalhousie University, Halifax, Canada
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Coleman A, Reis O, Clay A, Ramsden VR, Hughes K. Intimidation or harassment among family medicine residents in Saskatchewan: a cross-sectional survey. CANADIAN MEDICAL EDUCATION JOURNAL 2023; 14:64-70. [PMID: 38045080 PMCID: PMC10690008 DOI: 10.36834/cmej.75364] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Introduction Up to 98% of practicing family physicians, and over 75% of resident physicians in Canada experience abusive incidents. Despite the negative consequences of abusive incidents, few residents report these events to their supervisors or institution. We sought to estimate the prevalence of abusive incidents experienced or witnessed by Saskatchewan family medicine residents (FMRs) and identify their responses to these events. Methods Anonymous survey invitations were emailed to all 110 Saskatchewan FMRs in Saskatchewan in November and December 2020. Demographic characteristics, frequency of witnessed and experienced abusive incidents, sources of incidents and residents' responses were collected. Incidents were classified as minor, major, severe, or as racial discrimination based on a previously published classification system. Results The response rate was 34.5% (38/110). Ninety-two percent (35/38) of residents witnessed a minor incident and 91.7% (32/36) of residents experienced a minor incident. Seventy-one percent (27/38) of residents witnessed racial discrimination while 19.4% (7/36) of residents experienced racial discrimination. Patients were the most common source of abusive incidents. Twenty-nine percent of residents reported abusive incidents to their supervisors. Most residents were aware of institutional reporting policies. Conclusions Most Saskatchewan FMRs experienced or witnessed abusive incidents, but few were reported. This study provided the opportunity to reassess policies on abusive incidents, which should consider sources of abuse, confidence in reporting, and education.
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Affiliation(s)
- André Coleman
- College of Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Olivia Reis
- Academic Family Medicine, College of Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Adam Clay
- Academic Family Medicine, College of Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Vivian R Ramsden
- Academic Family Medicine, College of Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Kaitlyn Hughes
- Academic Family Medicine, College of Medicine, University of Saskatchewan, Saskatchewan, Canada
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Yolci A, Schenk L, Sonntag PT, Peppler L, Schouler-Ocak M, Schneider A. Observed and personally experienced discrimination: findings of a cross-sectional survey of physicians and nursing staff. HUMAN RESOURCES FOR HEALTH 2022; 20:83. [PMID: 36494666 PMCID: PMC9733037 DOI: 10.1186/s12960-022-00779-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 11/10/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Discrimination against hospital staff based on ascribed features is prevalent in healthcare systems worldwide. Detrimental effects on health and quality of patient care have been shown. Our study aims to describe and analyse the discrimination experiences of both physicians and nurses, specifically for the German hospital context. METHODS A cross-sectional online survey on observed and personally experienced discrimination at work addressed staff from 22 hospitals of two organizations in Germany. Sociodemographic and occupational as well as institutional characteristics served as independent variables. In multivariable analyses, block- and stepwise logistic regressions were calculated for the two dependent variables (witness and victim of discrimination). Sensitivity analyses with imputed data for missings were performed. RESULTS N = 800 healthcare professionals (n = 243 physicians, n = 557 nurses; response rate: 5.9%) participated in the survey. 305 respondents (38.1%) were witnesses of discrimination, while 108 respondents (13.5%) were victims of discrimination in their wards. Reasons for observed discriminatory acts were predominantly attributed to the ethnicity of the person concerned, their appearance and language, whereas personally affected staff most frequently cited gender as a reason, followed by ethnicity, and physical appearance. In multivariable models, cultural competence significantly increased the likelihood of witnessing discrimination (β = .575; p = .037). In terms of the likelihood of being a victim of discrimination, in addition to cultural competence (β = 2.838; p = < .001), the interaction of the effects of gender and professional group was statistically significant (β = .280; p = .010). CONCLUSIONS Given the extent of experienced and observed discrimination, appropriate institutional responses are needed. Further research on discriminatory structures in the German-speaking health care system should focus on discrimination at the intersection of ethnicity, gender and occupation.
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Affiliation(s)
- Arda Yolci
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Liane Schenk
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Pia-Theresa Sonntag
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Lisa Peppler
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Meryam Schouler-Ocak
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Psychiatrische Universitätsklinik der Charité im St. Hedwig-Krankenhaus, Berlin, Germany
| | - Anna Schneider
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
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Pereira-Sanchez V, Gürcan A, Gnanavel S, Vieira J, Asztalos M, Rai Y, Erzin G, Fontaine A, Pinto da Costa M, Szczegielniak A. Violence Against Psychiatric Trainees: Findings of a European Survey. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2022; 46:233-237. [PMID: 34606076 DOI: 10.1007/s40596-021-01539-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 09/16/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Violence by patients against health care professionals has been widely described. Although psychiatric trainees are particularly exposed, little is known about the extent, context, and impact of violence toward them in Europe. METHODS A cross-sectional online survey was distributed between June 2018 and December 2019 among European psychiatric trainees through professional networks, using a snowball approach. The questionnaire asked about experiences of verbal abuse and physical and sexual assaults, as well as their context and impact. Descriptive analyses of the obtained data were conducted. RESULTS The survey was completed by 827 trainees from 39 countries (68.4% females). Most (83.6%) reported having been abused/assaulted at least once (of these, 92% verbally, 44.1% physically, and 9.3% sexually). Emergency rooms and inpatient units were the most frequent settings. Psychological impact of these events was commonly reported. Most respondents did not report abuses and assaults to their supervisors. They also described a lack of training for staff and aggression management plans at their institutions or of being unaware of their existence. CONCLUSIONS Violence from patients is reported by many psychiatric trainees across countries in Europe, with very frequent verbal abuse and worrisome figures of physical and sexual assaults. Particularly concerning are the low proportion of trainees reporting to authorities, the lack of staff training and management protocols, and trainees' lack of awareness about those resources. Despite the study limitation of a small response rate, these results support a call for urgent efforts to address this problem in Europe, and possibly beyond.
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Affiliation(s)
| | - Ahmet Gürcan
- Başkent University Faculty of Medicine, Ankara, Turkey
| | | | | | | | - Yugesh Rai
- Essex Partnership University NHS Trust, Colchester, UK
| | - Gamze Erzin
- Başkent University Faculty of Medicine, Ankara, Turkey
| | - Audrey Fontaine
- Hôpital Corentin-Celton, Université de Paris, Issy-les-Moulineaux, France
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Tong JKC, Akpek E, Naik A, Sharma M, Boateng D, Andy A, Merchant RM, Kelz RR. Reporting of Discrimination by Health Care Consumers Through Online Consumer Reviews. JAMA Netw Open 2022; 5:e220715. [PMID: 35226076 PMCID: PMC8886543 DOI: 10.1001/jamanetworkopen.2022.0715] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
IMPORTANCE Little is known about how discrimination in health care relates to inequities in hospital-based care because of limitations in the ability to measure discrimination. Consumer reviews offer a novel source of data to capture experiences of discrimination in health care settings. OBJECTIVE To examine how health care consumers perceive and report discrimination through public consumer reviews. DESIGN, SETTING, AND PARTICIPANTS This qualitative study assessed Yelp online reviews from January 1, 2011, to December 31, 2020, of 100 randomly selected acute care hospitals in the US. Word filtering was used to identify reviews potentially related to discrimination by using keywords abstracted from the Everyday Discrimination Scale, a commonly used questionnaire to measure discrimination. A codebook was developed through a modified grounded theory and qualitative content analysis approach to categorize recurrent themes of discrimination, which was then applied to the hospital reviews. EXPOSURES Reported experiences of discrimination within a health care setting. MAIN OUTCOMES AND MEASURES Perceptions of how discrimination in health care is experienced and reported by consumers. RESULTS A total of 10 535 reviews were collected. Reviews were filtered by words commonly associated with discriminatory experiences, which identified 2986 reviews potentially related to discrimination. Using the codebook, the team manually identified 182 reviews that described at least 1 instance of discrimination. Acts of discrimination were categorized by actors of discrimination (individual vs institution), setting (clinical vs nonclinical), and directionality (whether consumers expressed discriminatory beliefs toward health care staff). A total of 53 reviews (29.1%) were coded as examples of institutional racism; 89 reviews (48.9%) mentioned acts of discrimination that occurred in clinical spaces as consumers were waiting for or actively receiving care; 25 reviews (13.7%) mentioned acts of discrimination that occurred in nonclinical spaces, such as lobbies; and 66 reviews (36.3%) documented discrimination by the consumer directed at the health care workforce. Acts of discrimination are described through 6 recurrent themes, including acts of commission, omission, unprofessionalism, disrespect, stereotyping, and dehumanizing. CONCLUSIONS AND RELEVANCE In this qualitative study, consumer reviews were found to highlight recurrent patterns of discrimination within health care settings. Applying quality improvement tools, such as the Plan-Do-Study-Act cycle, to this source of data and this study's findings may help inform assessments and initiatives directed at reducing discrimination within the health care setting.
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Affiliation(s)
- Jason K. C. Tong
- National Clinician Scholars Program, Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania
- Center for Surgery and Health Economics, Hospital of the University of Pennsylvania, Philadelphia
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Leonard Davis Institute of Health Economics, Philadelphia, Pennsylvania
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Eda Akpek
- Penn Mixed Methods Research Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Anusha Naik
- Center for Surgery and Health Economics, Hospital of the University of Pennsylvania, Philadelphia
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Medha Sharma
- Center for Surgery and Health Economics, Hospital of the University of Pennsylvania, Philadelphia
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Danielle Boateng
- Center for Surgery and Health Economics, Hospital of the University of Pennsylvania, Philadelphia
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Anietie Andy
- Center for Digital Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Raina M. Merchant
- Leonard Davis Institute of Health Economics, Philadelphia, Pennsylvania
- Center for Digital Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department for Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Rachel R. Kelz
- Center for Surgery and Health Economics, Hospital of the University of Pennsylvania, Philadelphia
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Leonard Davis Institute of Health Economics, Philadelphia, Pennsylvania
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia
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Siad FM, Rabi DM. Harassment in the Field of Medicine: Cultural Barriers to Psychological Safety. CJC Open 2022; 3:S174-S179. [PMID: 34993446 PMCID: PMC8712706 DOI: 10.1016/j.cjco.2021.08.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/25/2021] [Indexed: 11/30/2022] Open
Abstract
Psychologically safe organizational cultures are inherently inclusive and promote healthy sharing of power and knowledge. These conditions allow innovation to thrive and optimize member performance. Unfortunately, despite its evidence-based nature, the field of medicine continues to struggle with providing safe environments for its members. Several cultural barriers to psychological safety permit endemic harassment. These include having large power gradients, a weak ethical climate, and a number of enabling structural factors that maintain a toxic culture. Moving toward psychological safety will be challenging work, as it requires a difficult and complex analysis of the shared value system that enables the status quo. Programs and policies that promote equity, diversity, and inclusion are an important start, but they are likely insufficient on their own to achieve psychological safety. Leadership that models difficult reflection and supports inclusive transformation is the key to a safe culture shift.
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Affiliation(s)
- Fartoon M Siad
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Doreen M Rabi
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Cardiac Science Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Silkens MEWM, Sarker SJ, Medisauskaite A. Uncovering trends in training progression for a national cohort of psychiatry trainees: discrete-time survival analysis. BJPsych Open 2021; 7:e120. [PMID: 34184624 PMCID: PMC8269924 DOI: 10.1192/bjo.2021.958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The global rise in mental health issues calls for a strong psychiatry workforce. Yet, psychiatry training worldwide is facing recruitment challenges, causing unfilled consultant posts and possibly threatening the quality of patient care. An in-depth understanding of trainees' progression through training is warranted to explore what happens to recruited trainees during training. AIMS To uncover current trends in psychiatry trainees' progression through training in the UK. METHOD This national retrospective cohort study with data from the UK Medical Education Database used discrete-time survival analysis to analyse training progression for those trainees who started their core psychiatry post in 2012-2017 (2820 trainees; 59.6% female, 67.6% UK graduates (UKGs)). The impact of sociodemographic characteristics on training progression were also investigated. RESULTS The overall probability of completing training in 6 years (minimum years required to complete psychiatry training in the UK) was 17.2% (ranging from 4.8% for non-UKG females to 29% for UKG males). The probability to not progress was highest (57.1%) from core to specialty training. For UKGs, trainees from ethnicities other than White, trainees with a disability, and trainees who had experienced childhood social deprivation (measured as entitlement to free school meals) had a significantly (P ≤ 0.02) lower probability of completing training in 6 years. CONCLUSIONS Less than one in five psychiatry trainees are likely to complete training in 6 years and this probability varies across groups of doctors. Completing psychiatry training in 6 years is, therefore, the exception rather than the norm and this has important implications for trainees, those planning psychiatry workforces or responsible for psychiatry training.
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Affiliation(s)
- Milou E W M Silkens
- Research Department of Medical Education, UCL Medical School, University College London, UK
| | - Shah-Jalal Sarker
- Research Department of Medical Education, UCL Medical School, University College London, UK; and UCL Queen Square Institute of Neurology, School of Life & Medical Sciences, University College London, UK
| | - Asta Medisauskaite
- Research Department of Medical Education, UCL Medical School, University College London, UK
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The impact of organizational culture on professional fulfillment and burnout in an academic department of medicine. PLoS One 2021; 16:e0252778. [PMID: 34106959 PMCID: PMC8189486 DOI: 10.1371/journal.pone.0252778] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 05/21/2021] [Indexed: 11/19/2022] Open
Abstract
Physician wellness is vital to career satisfaction, provision of high quality patient care, and the successful education of the next generation of physicians. Despite this, the number of physicians experience symptoms of burnout is rising. To assess the impact of organizational culture on physicians' professional fulfillment and burnout, we surveyed full-time Department of Medicine members at the University of Toronto. A cross-sectional survey assessed: physician factors (age, gender, minority status, disability, desire to reduce clinical workload); workplace culture (efforts to create a collegial environment, respectful/civil interactions, confidence to address unprofessionalism without reprisal, witnessed and/or personally experienced unprofessionalism); professional fulfillment and burnout using the Stanford Professional Fulfillment Index. We used multivariable linear regression to examine the relationship of measures of workplace culture on professional fulfillment and burnout (scores 0-10), controlling for physician factors. Of 419 respondents (52.0% response rate), we included 400 with complete professional fulfillment and burnout data in analyses (60% ≤ age 50, 45% female). Mean scores for professional fulfillment and burnout were 6.7±1.9 and 2.8±1.9, respectively. Controlling for physician factors, professional fulfillment was associated with satisfaction with efforts to create a collegial environment (adjusted beta 0.45, 95% CI 0.21 to 0.70) and agreement that colleagues were respectful/civil (adjusted beta 0.85, 95% CI 0.53 to 1.17). Lower professional fulfillment was associated with higher burnout scores. Controlling for professional fulfillment and physician factors, lower confidence in taking action to address unprofessionalism (adjusted beta -0.22, 95% CI -0.40 to -0.03) was associated with burnout. Organizational culture and physician factors had an impact on professional fulfillment and burnout. Professional fulfillment partially mediated the relationship between organizational culture and burnout. Strategies that promote inclusion, respect and civility, and safe ways to report workplace unprofessionalism are needed in academic medicine.
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Malik MA, Inam H, Martins RS, Janjua MBN, Zahid N, Khan S, Sattar AK, Khan S, Haider AH, Enam SA. Workplace mistreatment and mental health in female surgeons in Pakistan. BJS Open 2021; 5:6284043. [PMID: 34037208 PMCID: PMC8152181 DOI: 10.1093/bjsopen/zrab041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 03/22/2021] [Indexed: 11/18/2022] Open
Abstract
Background Despite workplace mistreatment, which includes harassment, bullying and gender discrimination(GD)/bias, being serious problems for female surgeons, there are limited data from lower–middle-income countries like Pakistan. This study explored harassment and GD/bias experienced by female surgeons in Pakistan, and the effects of these experiences on mental health and well-being. Methods A nationwide survey was conducted between July and September 2019 in collaboration with the Association of Women Surgeons of Pakistan, an organization consisting of female surgeons and trainees in Pakistan. An anonymous online survey was emailed directly, disseminated via social media platforms (such as Facebook, Twitter and Instagram), and sent to surgical programmes in Pakistan. Results A total of 146 women surgeons responded to the survey; 67.1 per cent were trainees and the rest attending surgeons. Overall, 57.5 per cent of surgeons reported experiencing harassment, most common being verbal (64.0 per cent) and mental (45.9 per cent), but this mostly went unreported (91.5 per cent). On multivariable analysis adjusted for age and specialty, workplace harassment (odds ratio 2.02 (95 per cent c.i. 1.09 to 4.45)) and bullying (odds ratio 5.14 (95 per cent c.i. 2.00–13.17)) were significantly associated with severe self-perceived burnout, while having a support system was protective against feelings of depression (odds ratio 0.35 (95 per cent c.i. 0.16 to 0.74)). The overwhelming majority (91.3 per cent) believed that more institutional support groups were needed to help surgeons with stress reduction (78.8 per cent), receiving mentorship (74.7 per cent) and work–life balance (67.8 per cent). Conclusion Workplace mistreatment, in particular harassment and bullying, has a damaging impact on the mental well-being of female surgeons, particularly trainees. The absence of support groups in Pakistan should be urgently addressed so that surgeons, especially trainees, may cope better with potentially harmful workplace stressors.
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Affiliation(s)
- M A Malik
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - H Inam
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - R S Martins
- Medical College, Aga Khan University Hospital, Karachi, Pakistan
| | - M B N Janjua
- Department of Surgery, Howard University Hospital, Washington, DC, USA
| | - N Zahid
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - S Khan
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - A K Sattar
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - S Khan
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - A H Haider
- Medical College, Aga Khan University Hospital, Karachi, Pakistan
| | - S A Enam
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
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