Chen Allen M
Department of Radiation Oncology, University of California, Irvine, Chao Family Comprehensive Cancer Center, Orange, CA 92868, USA.
Future Healthc J. 2025 Jun 30;12(3):100448. doi: 10.1016/j.fhj.2025.100448. eCollection 2025 Sep.
The aim of this study was to identify and evaluate published interventional strategies that address disruptive physician behaviour.
This study was designed based on the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) statement. A comprehensive literature search of publications from January 2013 to November 2023 was undertaken to identify original peer-reviewed studies pertaining to the development and implementation of targeted strategies for the management of disruptive physicians. An interpretive synthesis of the available publications was then presented in both tabular and descriptive format.
Among the 1,005 original articles that entered the final selection process, a total of 998 were then excluded because they were focused solely on the characterisation of disruptive behaviour (n=399); limited to trainees (n=258), limited to ancillary staff (n=135); concentrated on prevention (n=111); and described consequences (n=95). A total of seven original publications thus met criteria for inclusion and differed in their design, methods and endpoints. Two articles reported on longitudinal experiences involving prospective data. The most commonly identified themes related to accountability (five studies), organisational commitment (four studies) and professionalism training (three studies), with most studies covering more than one item.
Given the practical scope of this problem, a relative lack of publications exist focused on remediation strategies for disruptive physician behaviour. Investment in the development of evidence-based programmes are warranted.
本研究旨在识别和评估已发表的针对医生破坏性行为的干预策略。
本研究基于系统评价与Meta分析方案的首选报告项目（PRISMA-P）声明进行设计。对2013年1月至2023年11月期间发表的文献进行了全面检索，以确定与制定和实施针对破坏性行为医生的针对性策略相关的同行评审原始研究。然后以表格和描述性形式对现有出版物进行解释性综合。
在进入最终筛选过程的1005篇原始文章中，共有998篇被排除，因为它们仅关注破坏性行为的特征描述（n = 399）；仅限于实习生（n = 258），仅限于辅助人员（n = 135）；专注于预防（n = 111）；以及描述后果（n = 95）。因此，共有七篇原始出版物符合纳入标准，它们在设计、方法和终点方面存在差异。两篇文章报告了涉及前瞻性数据的纵向经验。最常确定的主题与问责制（五项研究）、组织承诺（四项研究）和专业培训（三项研究）相关，大多数研究涵盖多个项目。
鉴于这个问题的实际范围，针对医生破坏性行为的补救策略的出版物相对较少。有必要投资开发基于证据的项目。
