Mayo Clinic Health System, Department of Emergency Medicine, Eau Claire, Wisconsin.
Mayo Clinic, Department of Emergency Medicine, Rochester, Minnesota.
West J Emerg Med. 2022 Aug 19;23(5):633-636. doi: 10.5811/westjem.2022.6.55485.
Horizontal violence (HV) is defined as "persistent exposure to interpersonal aggression and mistreatment from colleagues." Our objective in this pilot, single-site study was to identify sources of HV toward emergency medicine (EM) residents, using the Negative Acts Questionnaire-Revised (NAQ-R).
In this investigation we used a descriptive cross-sectional survey design to categorize HV. All voluntary participants were residents in an Accreditation Council for Graduate Medical Education-approved, three-year academic EM residency. Data were collected via electronic survey and occurred six months into an academic year. We collected demographic information and responses to the NAQ-R in 2020. Horizontal violence is subdivided into three categories: work-related; person-related; and physical intimidation. Emergency medicine residents answered questions as they related to their interactions with residents and support staff, which included nursing.
A total of 23 of 26 residents responded (89%). Participants were 56% women, 78% white, 11% Hispanic, and 89% heterosexual. Participant clinical year was 39% first-, 39% second-, and 22% third-year residents. Women reported a higher frequency of HV compared to men (1.3 vs 1.1, P =.01). By category, women indicated higher incidence of work-related violence from other residents (P = .05) and staff (P =.02). There was no difference in reported frequency of violence for interns compared to senior residents.
Our pilot study demonstrated horizontal violence toward EM residents exists and is more prevalent in women.
横向暴力（HV）被定义为“持续遭受同事的人际攻击和虐待”。我们在这项试点、单站点研究中的目的是使用修订后的负面行为问卷（NAQ-R）确定急诊医学（EM）住院医师遭受 HV 的来源。
在这项调查中，我们使用描述性的横断面调查设计来对 HV 进行分类。所有自愿参加的参与者都是在经过认可委员会研究生医学教育认证的为期三年的学术急诊医学住院医师培训计划中的住院医师。数据通过电子调查收集，并在一个学术年的六个月时进行。我们在 2020 年收集了人口统计学信息和对 NAQ-R 的回答。横向暴力分为三类：与工作相关的；与人相关的；和身体恐吓。急诊医学住院医师根据与住院医师和支持人员（包括护士）互动相关的问题回答问题。
共有 26 名住院医师中的 23 名（89%）做出了回应。参与者中 56%为女性，78%为白人，11%为西班牙裔，89%为异性恋。参与者的临床年分为 39%的第一年住院医师、39%的第二年住院医师和 22%的第三年住院医师。与男性相比，女性报告的 HV 频率更高（1.3 对 1.1，P=.01）。按类别划分，女性报告来自其他住院医师（P=.05）和工作人员（P=.02）的工作相关暴力发生率更高。实习生报告的暴力频率与高级住院医师没有差异。
我们的试点研究表明，急诊医学住院医师存在 HV，并且女性更为普遍。
