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Review
. 2020 Mar 16;11(1):e97-e123.
doi: 10.36834/cmej.57019. eCollection 2020 Mar.

Prevalence of intimidation, harassment, and discrimination among resident physicians: a systematic review and meta-analysis

Anees Bahji  1   2 , Josephine Altomare  1
Affiliations
Review

Prevalence of intimidation, harassment, and discrimination among resident physicians: a systematic review and meta-analysis

Anees Bahji et al. Can Med Educ J. .

Abstract
in English, French

Background: The aim of this study was to establish the prevalence of intimidation, harassment, and discrimination (IHD) reported by resident physicians during their training, to identify factors associated with reported IHD, and to identify adverse sequalae associated with IHD.

Methods: This review followed the PRISMA guidelines. Eight electronic databases were searched for cross-sectional studies reporting the prevalence of IHD among resident physicians. Prevalence estimates were pooledacross studies using random-effects meta-analysis, with variance stabilization using Tukey double arcsine transformation. Heterogeneity was assessed with forest plots, the I 2 statistic, subgroup analyses, and multivariate meta-regression.

Results: 52 cross-sectional studies were included in the meta-analysis. The overall pooled prevalence of IHD was 64.1% (95% confidence interval [CI], 51.0-77.1). Verbal, physical, and sexual IHD were the most common forms of IHD reported by residents. Training status (55.5%), gender (41.7%), and ethnicity (20.6%) were the most commonly cited risk factors for IHD. The most common sources of IHD were relatives/friends of patients, nurses, and patients (cited by 50.7%, 47.8, and 41.7%, respectively).

Conclusions: The prevalence of IHD among resident physicians is high and associated with multiple negative outcomes, including burnout. Despite the availability of multiple anti-IHD interventions, reports of IHD appear to be rising in many residency programs.

Objectif: Cette étude visait à établir la prévalence de l’intimidation, du harcèlement et de la discrimination (IHD) signalés par les médecins résidents pendant leur formation, àdéterminer les facteurs associés au signalement del’IHDet à identifier les effets néfastes associés à l’IHD.

Méthodes: Cette revue a suivi les lignes directricesde la méthode PRISMA surles revuessystématiques et les méta-analyses. Nous avons utiliséhuit bases de données électroniques pour trouver des études transversales ayant fait état de la fréquence des comportements d’IDH parmi les médecins résidents. Les estimations sur la prévalencede l’IHD ont été obtenues sur la basede méta-analyses d’effets randomisés, avec une la stabilisation de la variance grâce à la double transformation arcsine de Tukey. L’hétérogénéité a été évaluée qualitativement à l’aide de graphiques en forêt et quantitativement en utilisant la statistique I 2 , des analyses de sous-groupes et la méta-régression multivariée.

Résultats: 52 études transversales ont répondu aux critères d’inclusions. L’ensemble des prévalences regroupéesd’IHD était de 64,1 % (95 % IC, 51.0-77.1). Les formes verbales, physiques et sexuelles étaient les IHD les plus fréquemment signalées par les résidents. Le niveau de formation (55,5 %), le sexe (41,7 %) et l’ethnicité (20,6 %) étaient les trois facteurs de risque les plus couramment cités concernant l’IHD.. Les sources les plus communes de l’IHD étaient les parents/amis des patients, les infirmières et les patients (cité par 50,7 %, 47,8 % et 41,7 %, respectivement).

Conclusions: La prévalencede l’IDH auprèsdes médecins résidents est élevée et associée à plusieurs conséquences négatives, notamment l’épuisement professionnel. Malgré la disponibilitéde plusieurs interventions anti-IHD, les signalements d’IDH semblent être à la hausse dans plusieurs juridictions.

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Conflict of interest statement

Conflicts of interest: The authors have no financial or other conflicts of interest to disclose.

Figures

Figure 1
Figure 1
PRISMA study flow diagram
Figure 2
Figure 2
Meta-analysis of prevalence of overall Intimidation, Harassment, and Discrimination across all studies.
See this image and copyright information in PMC

References

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