Workplace bullying and sexual harassment among general surgery residents in Colombia

Luis Carlos Domínguez , Lilian Torregrosa , Liliana Cuevas, Laura Peña , Sebastián Sánchez , Mauricio Pedraza , Álvaro Sanabria, .

Keywords: occupational stress, sexual harassment, medical staff, hospital, crosssectional studies

Abstract

Introduction. Workplace bullying and sexual harassment are concerns among general surgery residents in Colombia.
Objective. To explore the prevalence and impact of workplace bullying and sexual harassment incidents among general surgery residents in Colombia.
Materials and methods. This nationwide study was conducted in 2020. Residents selfrated their exposure to workplace bullying and to sexual harassment in the forms of gender harassment, unwanted sexual attention, and sexual coercion. We analyzed demographic variables, perpetrator’s characteristics, and differences between victims and non-victims.
Results. The study included 302 residents. It found that 49% of general surgery residents in Colombia suffered from workplace bullying and 14.9% experienced sexual harassment. The main forms of sexual harassment were gender harassment (47%) and unwanted sexual attention (47%). Women reported significantly higher rates of being sexually harassed. Surgeons were the main perpetrators of sexual harassment.
Conclusions. Workplace bullying and sexual harassment are frequent events in general surgery residency in Colombia. These findings suggest the need for interventions to improve the educational culture of surgical departments and decrease the prevalence of these behaviors.

Downloads

Download data is not yet available.

References

Gianakos AL, Freischlag JA, Mercurio AM, Haring RS, LaPorte DM, Mulcahey MK, et al. Bullying, discrimination, harassment, sexual harassment, and the fear of retaliation during surgical residency training: A systematic review. World J Surg. 2022;46:1587-99. https://doi.org/10.1007/s00268-021-06432-6

Jackson T, Provencio A, Bentley-Kumar K, Pearcy C, Cook T, McLean K, et al. PTSD and surgical residents: Everybody hurts sometimes. Am J Surg. 2017;214:1118-24. https://doi.org/10.1016/j.amjsurg.2017.08.037

Halim UA, Riding DM. Systematic review of the prevalence, impact and mitigating strategies for bullying, undermining behaviour and harassment in the surgical workplace. Br J Surg. 2018;105:1390-7. https://doi.org/10.1002/bjs.10926

Messiaen M, Duba A, Boulangeat C, Boucekine M, Bourbon A, Viprey M, et al. Repeated bullying at the workplace in medical students and young doctors: the MESSIAEN national study. Eur Arch Psychiatry Clin Neurosci. 2021;271:1123-31. https://doi.org/10.1007/s00406-020-01144-9

Wild JR, Ferguson HJ, McDermott FD, Hornby ST, Gokani VJ, Council of the Association of Surgeons in Training. Undermining and bullying in surgical training: A review and recommendations by the Association of Surgeons in Training. Int J Surg. 2015;23(Suppl.1):S5-9. https://doi.org/10.1016/j.ijsu.2015.09.017

Lases LSS, Arah OA, Busch ORC, Heineman MJ, Lombarts K. Learning climate positively influences residents’ work-related well-being. Adv Health Sci Educ Theory Pract. 2019;24:317-30. https://doi.org/10.1007/s10459-018-9868-4

Holzgang M, Koenemann N, Skinner H, Burke J, Smith A, Young A. Discrimination in the surgical discipline: an international European evaluation (DISDAIN). BJS Open. 2021;5. https://doi.org/10.1093/bjsopen/zrab050

Ellis RJ, Nicolas JD, Cheung E, Zhang L, Ma M, Turner P, et al. Comprehensive characterization of the general surgery residency learning environment and the association with resident burnout. Ann Surg. 2021;274:6-11. https://doi.org/10.1097/SLA.0000000000004796

Freedman-Weiss MR, Chiu AS, Heller DR, Cutler AS, Longo WE, Ahuja N, et al. Understanding the barriers to reporting sexual harassment in surgical training. Ann Surg. 2020;271:608-13. https://doi.org/10.1097/SLA.0000000000003295

Parini S, Lucidi D, Azzolina D, Verdi D, Frigerio I, Gumbs AA, et al. Women in Surgery Italia: National Survey Assessing Gender-Related Challenges. J Am Coll Surg. 2021;233:583-92. https://doi.org/10.1016/j.jamcollsurg.2021.08.675

Ling M, Young CJ, Shepherd HL, Mak C, Saw RP. Workplace bullying in surgery. World J Surg. 2016;40:2560-6. https://doi.org/10.1007/s00268-016-3642-7

Ellis RJ, Hewitt DB, Hu YY, Johnson JK, Merkow RP, Yang AD, et al. An empirical national assessment of the learning environment and factors associated with program culture. Ann Surg. 2019;270:585-92. https://doi.org/10.1097/SLA.0000000000003545

Orlino JP, Sura TA, Pei KY, Smeds MR. Bullying of vascular surgery trainees. J Vasc Surg. 2022;75:2065-71. https://doi.org/10.1016/j.jvs.2022.01.123

Smith-Han K, Collins E, Asil M, Blakey AG, Anderson L, Berryman E, et al. Measuring exposure to bullying and harassment in health professional students in a clinical workplace environment: Evaluating the psychometric properties of the clinical workplace learning NAQ-R scale. Med Teach. 2020;42:813-21. https://doi.org/10.1080/0142159X.2020.1746249

National Academies of Sciences, Engineering, and Medicine. Sexual harassment of women: Climate, culture, and consequences in academic sciences, engineering, and medicine. Johnson P, Widnall S, Benya F, eds. Washington, D.C.: The National Academies Press; 2018. Accesses: September 4, 2022. Available at: https://nap.nationalacademies.org/catalog/24994/sexual-harassment-of-women-climate-culture-and-consequences-inacademic

Beveraggi EM. Surgery in Argentina. Arch Surg. 1999;134:438-44. https://doi.org/10.1001/archsurg.134.4.438

Orozco H, Mercado MA. Surgery in Mexico. Arch Surg. 2000;135:226-8. https://doi.org/10.1001/archsurg.135.2.226

Ferreira EA, Rasslan S. Surgical education in Brazil. World J Surg. 2010;34:880-3. https://doi.org/10.1007/s00268-009-0264-3

Meara JG, Leather AJ, Hagander L, Alkire BC, Alonso N, Ameh EA, et al. Global Surgery 2030: Evidence and solutions for achieving health, welfare, and economic development. Surgery. 2015;158:3-6. https://doi.org/10.1016/j.surg.2015.04.011

Sarmiento-Altamirano D, Himmler A, Cabrera-Ordóñez C, Olmedo-Abril S, Biondi A, Di-Saverio S. Gender disparities in Ecuador: a survey study of the under-representation of women in surgery. Updates Surg. 2021;73:2009-15. https://doi.org/10.1007/s13304-020-00964-7

Boffa C, Ceresa CDL, Vig S, Knight SR, Royston E, Quiroga I, et al. Zero tolerance to sexual harassment in surgical training in the UK. Br J Surg. 2021;108:e345-6. https://doi.org/10.1093/bjs/znab276

Fitzgerald CA, Smith RN, Luo-Owen X, Turay D, Ferrada P, Han J, et al. Screening for harassment, abuse, and discrimination among surgery residents: An EAST Multicenter Trial. Am Surg. 2019;85:456-61.

Miller P. #MeToo in Surgery: Narratives by women surgeons. Narrat Inq Bioeth. 2019;9:179- 83. https://doi.org/10.1353/nib.2019.0060

Zhang D, Pistorio AL, Payne D, Lifchez SD, American Society for Surgery of the Hand E, Professionalism C. Promoting gender equity in the #MeToo Era. J Hand Surg Am. 2020;45:1167-72. https://doi.org/10.1016/j.jhsa.2020.07.004

Angelos P. The value of speaking up. Narrat Inq Bioeth. 2019;9:229-31. https://doi.org/10.1353/nib.2019.0069

Moreno-Jiménez B, Rodríguez-Muñoz A, Martínez-Gamarra M, Galvez-Herrer M. Assessing workplace bullying: Spanish validation of a reduced version of the Negative Acts Questionnaire. Span J Psychol. 2007;10:449-57.

Huang Y, Chua TC, Saw RPM, Young CJ. Discrimination, bullying and harassment in surgery: a systematic review and meta-analysis. World J Surg. 2018;42:3867-73. https://doi.org/10.1007/s00268-018-4716-5

Nagata-Kobayashi S, Maeno T, Yoshizu M, Shimbo T. Universal problems during residency: abuse and harassment. Med Educ. 2009;43:628-36. https://doi.org/10.1111/j.1365-2923.2009.03388.x

Martins RS, Hashmi SA, Inam H, Naeem Janjua MB, Malik MA. Harassment and mental health in surgical training: a pilot survey of surgical trainees in Pakistan. J Pak Med Assoc. 2021;71(Suppl.1):S23-8.

Crebbin W, Campbell G, Hillis DA, Watters DA. Prevalence of bullying, discrimination and sexual harassment in surgery in Australasia. ANZ J Surg. 2015;85:905-9. https://doi.org/10.1111/ans.13363

Hu YY, Ellis RJ, Hewitt DB, Yang AD, Cheung EO, Moskowitz JT, et al. Discrimination, abuse, harassment, and burnout in surgical residency training. N Engl J Med. 2019;381:1741-52. https://doi.org/10.1056/NEJMsa1903759

Lucas-Guerrero V, Pascua-Sole M, Ramos-Rodríguez JL, Trinidad-Borras A, González de Pedro C, Jover-Navalon JM, et al. Burnout in general surgery residents. Survey from the Spanish Association of Surgeons. Cir Esp (Engl Ed). 2020;98:442-9. https://doi.org/10.1016/j.ciresp.2020.04.013

Clements JM, King M, Nicholas R, Burdall O, Elsey E, Bucknall V, et al. Bullying and undermining behaviours in surgery: A qualitative study of surgical trainee experiences in the United Kingdom (UK) and Republic of Ireland (ROI). Int J Surg. 2020;84:219-25. https://doi.org/10.1016/j.ijsu.2020.07.031

Schlick CJR, Ellis RJ, Etkin CD, Greenberg CC, Greenberg JA, Turner PL, et al. Experiences of gender discrimination and sexual harassment among residents in general surgery programs across the US. JAMA Surg. 2021;156:942-52. https://doi.org/10.1001/jamasurg.2021.3195

Zhang LM, Ellis RJ, Ma M, Cheung EO, Hoyt DB, Bilimoria KY, et al. Prevalence, types, and sources of bullying reported by US general surgery residents in 2019. JAMA. 2020;323:2093-5. https://doi.org/10.1001/jama.2020.2901

De la Cerda-Vargas MF, Stienen MN, Campero A, Pérez-Castell AF, SorianoSánchez JA, Nettel-Rueda B, et al. Burnout, discrimination, abuse, and mistreatment in Latin America Neurosurgical training during the coronavirus disease 2019 pandemic. World Neurosurg. 2022;158:e393-e415. https://doi.org/10.1016/j.wneu.2021.10.188

How to Cite
1.
Domínguez LC, Torregrosa L, Cuevas L, Peña L, Sánchez S, Pedraza M, et al. Workplace bullying and sexual harassment among general surgery residents in Colombia. biomedica [Internet]. 2023 Jun. 30 [cited 2024 May 16];43(2):252-60. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/6915
Published
2023-06-30
Section
Original articles

Altmetric

Article metrics
Abstract views
Galley vies
PDF Views
HTML views
Other views
QR Code