Department of Health, Policy and Hospital Management, School of Public Health, Harbin Medical University, Harbin, 150081, China.
Department of Internal Medicine, Heilongjiang Academy of Chinese Medicine Science, Harbin, 150081, China.
BMC Public Health. 2022 Jun 1;22(1):1090. doi: 10.1186/s12889-022-13497-y.
Workplace violence is internationally recognised as a major concern for the workforce, which entails serious consequences, and research shows that medical residents are more likely than other doctors to experience violence in the workplace. This study first examines the effectiveness of simulation-based medical education, and then simulation-based medical education combined with behavioural economics as interventions in medical residents' perception of, attitude toward, and self-efficacy in coping with violence in the workplace.
A quasi-experimental design was used, 190 participants were randomised into three study groups to respectively test the effect of simulation-based medical education only and simulation-based medical education plus behavioural economics interventions, compared with a control group. Data were obtained from structured questionnaires, including (1) a perception of aggression scale, a management of aggression and violence attitude scale, a general self-efficacy scale, and (2) socio-demographic characteristics.
The results show that the scores attained by simulation-based medical education (SBME) and simulation-based medical education combined with behavioural economics (SBME + BE) interventions for perception, attitude, and self-efficacy were significantly higher than those in the control group (p < .01). The SBME + BE group recorded a greater improvement in perception, which could be ascribed to the behavioural economics effect. Furthermore, the higher perception of workplace violence is correlated with single residents and those with more work experience, prior experiences of violence in the workplace, and training related to workplace violence. A higher positive correlation of workplace violence was recorded by female and widowed residents,and a higher level of self-efficacy related to violence in the workplace correlated with male, widowed,and senior (third-year) residents.
This study contributes important evidence regarding changes in the perception, attitude, and self-efficacy of subjects following both the SBME + BE and SBME interventions among medical residents in coping with workplace violence, the biggest perception change having been recorded after the SBME + BE intervention, which can be explained by the inclusion of behavioural economics.
workplace violence 已在国际上被公认为劳动力的一大关注点，其后果严重。研究表明，与其他医生相比，住院医师更有可能在工作场所遭受暴力。本研究首先考察了基于模拟的医学教育的有效性，然后考察了基于模拟的医学教育与行为经济学相结合的干预措施对住院医师对工作场所暴力的感知、态度和应对自我效能感的影响。
采用准实验设计，将 190 名参与者随机分为三组，分别测试基于模拟的医学教育和基于模拟的医学教育加行为经济学干预的效果，与对照组进行比较。数据来自结构化问卷，包括（1）攻击性感知量表、攻击性和暴力管理态度量表、一般自我效能感量表，以及（2）社会人口统计学特征。
结果表明，基于模拟的医学教育（SBME）和基于模拟的医学教育与行为经济学（SBME+BE）干预对感知、态度和自我效能的得分明显高于对照组（p<.01）。SBME+BE 组在感知方面的改善更为显著，这可归因于行为经济学的影响。此外，工作场所暴力的感知越高，与单身居民和工作经验丰富的居民、以前在工作场所遭受过暴力的经历以及与工作场所暴力相关的培训有关。女性和丧偶居民对工作场所暴力的相关性更高，与工作场所暴力相关的自我效能感更高，与男性、丧偶和高级（第三年）居民有关。
本研究为住院医师应对工作场所暴力的基于模拟的医学教育与行为经济学相结合的干预措施对主体的感知、态度和自我效能感的变化提供了重要证据，SBME+BE 干预后的感知变化最大，可以用行为经济学来解释。
