Department of Family Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY.
University of Rochester Department of Family Medicine, Rochester, NY.
Fam Med. 2021 Jun;53(6):408-415. doi: 10.22454/FamMed.2021.808187.
Health professionals may face sexual harassment from patients, faculty, and colleagues. Medicine's hierarchy deters response to sexual harassment. Current evidence consists largely of quantitative data regarding the frequency and types of sexual harassment. More information is needed about the nature of the experience and how or why professionals choose to report or respond.
We developed and administered a semistructured interview guide to elicit family medicine faculty and residents' experiences with sexual harassment and gender bias. Facilitators led a series of focus groups divided by faculty (N=28) and residents (N=24). We ensured voluntary consent and groups were audiotaped, transcribed and deidentified. We coded the transcripts using immersion-crystallization theory to identify emergent themes.
Sexual harassment from patients and colleagues was described as witnessed or personally experienced by faculty and resident participants in 100% of the focus groups. Respondents identified the presence of mentors, clear reporting process and follow-up, history of good organizational response to reporting, and education and training as facilitators to reporting sexual harassment. Barriers to reporting included fear of retaliation, lack of trust of the system to respond, lack of clarity about "what counts," and confusion with the reporting process.
It is important to capitalize on facilitators to reporting sexual harassment, starting with acknowledging the frequency of sexual harassment and gender discrimination. Addressing barriers to responding through education and training for our learners and faculty is critical. Clarifying the reporting process, having clear expectations for behavior, and a continuum of responses may help increase the frequency of reporting.
医疗专业人员可能会遭受来自患者、教员和同事的性骚扰。医学领域的层级制度阻碍了对性骚扰的应对。目前的证据主要是关于性骚扰的频率和类型的定量数据。我们需要更多关于性骚扰经历的性质,以及专业人员选择报告或回应的方式或原因的信息。
我们开发并实施了一份半结构化访谈指南,以了解家庭医学教员和住院医师遭受性骚扰和性别偏见的经历。主持人引导了一系列按教员(N=28)和住院医师(N=24)划分的焦点小组。我们确保了自愿同意,对小组进行了录音、转录和匿名处理。我们使用沉浸式结晶理论对转录本进行编码,以确定新兴主题。
在所有焦点小组中,教员和住院医师参与者都描述了他们目睹或亲身经历过来自患者和同事的性骚扰。受访者确定了导师的存在、明确的报告流程和跟进、组织对报告性骚扰的良好回应历史、教育和培训是报告性骚扰的促进因素。报告的障碍包括害怕报复、对系统回应的信任缺失、对“什么算”缺乏明确性,以及对报告流程的困惑。
利用促进报告性骚扰的因素非常重要,首先要承认性骚扰和性别歧视的频率。通过对我们的学习者和教员进行教育和培训来解决回应的障碍至关重要。通过明确报告流程、对行为有明确的期望以及提供一系列回应措施,可能有助于增加报告的频率。