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. 2022 Aug 19;23(5):633-636.
doi: 10.5811/westjem.2022.6.55485.

Horizontal Violence Toward Emergency Medicine Residents: Gender as a Risk Factor

Ashley A Jacobson  1 , James E Colletti  2 , Neha P Raukar  2
Affiliations

Horizontal Violence Toward Emergency Medicine Residents: Gender as a Risk Factor

Ashley A Jacobson et al. West J Emerg Med. .

Abstract

Introduction: 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).

Methods: 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.

Results: 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.

Conclusion: Our pilot study demonstrated horizontal violence toward EM residents exists and is more prevalent in women.

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Conflict of interest statement

Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. No author has professional or financial relationships with any companies that are relevant to this study. There are no conflicts of interest or sources of funding to declare.

Figures

Figure
Figure
Horizontal violence (HV) presented as average survey response and broken down by gender and the three subcategories of HV: work-related, person-related, and physical intimidation. The self-reported frequency of violence is scored from 1 (never) to 5 (daily). Women experienced a higher incidence of work-related violence, both from other residents (P =.05) and from support staff members (P =.02). This was statistically significant in comparison to men.
See this image and copyright information in PMC

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