Browsing by Subject "Sexual harassment"
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Item Experiences of Gender Discrimination and Sexual Harassment Among Residents in General Surgery Programs Across the US(American Medical Association, 2021) Schlick, Cary Jo R.; Ellis, Ryan J.; Etkin, Caryn D.; Greenberg, Caprice C.; Greenberg, Jacob A.; Turner, Patricia L.; Buyske, Jo; Hoyt, David B.; Nasca, Thomas J.; Bilimoria, Karl Y.; Hu, Yue-Yung; Surgery, School of MedicineImportance: Mistreatment is a common experience among surgical residents and is associated with burnout. Women have been found to experience mistreatment at higher rates than men. Further characterization of surgical residents' experiences with gender discrimination and sexual harassment may inform solutions. Objective: To describe the types, sources, and factors associated with (1) discrimination based on gender, gender identity, or sexual orientation and (2) sexual harassment experienced by residents in general surgery programs across the US. Design, setting, and participants: This cross-sectional national survey study was conducted after the 2019 American Board of Surgery In-Training Examination (ABSITE). The survey asked respondents about their experiences with gender discrimination and sexual harassment during the academic year starting July 1, 2018, through the testing date in January 2019. All clinical residents enrolled in general surgery programs accredited by the Accreditation Council for Graduate Medical Education were eligible. Exposures: Specific types, sources, and factors associated with gender-based discrimination and sexual harassment. Main outcomes and measures: Primary outcome was the prevalence of gender discrimination and sexual harassment. Secondary outcomes included sources of discrimination and harassment and associated individual- and program-level factors using gender-stratified multivariable logistic regression models. Results: The survey was administered to 8129 eligible residents; 6956 responded (85.6% response rate)from 301 general surgery programs. Of those, 6764 residents had gender data available (3968 [58.7%] were male and 2796 [41.3%] were female individuals). In total, 1878 of 2352 female residents (79.8%) vs 562 of 3288 male residents (17.1%) reported experiencing gender discrimination (P < .001), and 1026 of 2415 female residents (42.5%) vs 721 of 3360 male residents (21.5%) reported experiencing sexual harassment (P < .001). The most common type of gender discrimination was being mistaken for a nonphysician (1943 of 5640 residents [34.5%] overall; 1813 of 2352 female residents [77.1%]; 130 of 3288 male residents [4.0%]), with patients and/or families as the most frequent source. The most common form of sexual harassment was crude, demeaning, or explicit comments (1557 of 5775 residents [27.0%] overall; 901 of 2415 female residents [37.3%]; 656 of 3360 male residents [19.5%]); among female residents, the most common source of this harassment was patients and/or families, and among male residents, the most common source was coresidents and/or fellows. Among female residents, gender discrimination was associated with pregnancy (odds ratio [OR], 1.93; 95% CI, 1.03-3.62) and higher ABSITE scores (highest vs lowest quartile: OR, 1.67; 95% CI, 1.14-2.43); among male residents, gender discrimination was associated with parenthood (OR, 1.72; 95% CI, 1.31-2.27) and lower ABSITE scores (highest vs lowest quartile: OR, 0.57; 95% CI, 0.43-0.76). Senior residents were more likely to report experiencing sexual harassment than interns (postgraduate years 4 and 5 vs postgraduate year 1: OR, 1.77 [95% CI, 1.40-2.24] among female residents; 1.31 [95% CI, 1.01-1.70] among male residents). Conclusions and relevance: In this study, gender discrimination and sexual harassment were common experiences among surgical residents and were frequently reported by women. These phenomena warrant multifaceted context-specific strategies for improvement.Item Experiences of LGBTQ+ Residents in US General Surgery Training Programs(American Medical Association, 2022) Heiderscheit, Evan A.; Schlick, Cary Jo R.; Ellis, Ryan J.; Cheung, Elaine O.; Irizarry, Dre; Amortegui, Daniela; Eng, Joshua; Sosa, Julie Ann; Hoyt, David B.; Buyske, Jo; Nasca, Thomas J.; Bilimoria, Karl Y.; Hu, Yue-Yung; Surgery, School of MedicineImportance: Previous studies have shown high rates of mistreatment among US general surgery residents, leading to poor well-being. Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) residents represent a high-risk group for mistreatment; however, their experience in general surgery programs is largely unexplored. Objective: To determine the national prevalence of mistreatment and poor well-being for LGBTQ+ surgery residents compared with their non-LGBTQ+ peers. Design, setting, and participants: A voluntary, anonymous survey adapting validated survey instruments was administered to all clinically active general surgery residents training in Accreditation Council for Graduate Medical Education-accredited general surgery programs following the 2019 American Board of Surgery In-Training Examination. Main outcomes and measures: Self-reported mistreatment, sources of mistreatment, perceptions of learning environment, career satisfaction, burnout, thoughts of attrition, and suicidality. The associations between LGBTQ+ status and (1) mistreatment, (2) burnout, (3) thoughts of attrition, and (4) suicidality were examined using multivariable regression models, accounting for interactions between gender and LGBTQ+ identity. Results: A total of 6956 clinically active residents completed the survey (85.6% response rate). Of 6381 respondents included in this analysis, 305 respondents (4.8%) identified as LGBTQ+ and 6076 (95.2%) as non-LGBTQ+. Discrimination was reported among 161 LGBTQ+ respondents (59.2%) vs 2187 non-LGBTQ+ respondents (42.3%; P < .001); sexual harassment, 131 (47.5%) vs 1551 (29.3%; P < .001); and bullying, 220 (74.8%) vs 3730 (66.9%; P = .005); attending surgeons were the most common overall source. Compared with non-LGBTQ+ men, LGBTQ+ residents were more likely to report discrimination (men: odds ratio [OR], 2.57; 95% CI, 1.78-3.72; women: OR, 25.30; 95% CI, 16.51-38.79), sexual harassment (men: OR, 2.04; 95% CI, 1.39-2.99; women: OR, 5.72; 95% CI, 4.09-8.01), and bullying (men: OR, 1.51; 95% CI, 1.07-2.12; women: OR, 2.00; 95% CI, 1.37-2.91). LGBTQ+ residents reported similar perceptions of the learning environment, career satisfaction, and burnout (OR, 1.22; 95% CI, 0.97-1.52) but had more frequent considerations of leaving their program (OR, 2.04; 95% CI, 1.52-2.74) and suicide (OR, 1.95; 95% CI, 1.26-3.04). This increased risk of suicidality was eliminated after adjusting for mistreatment (OR, 1.47; 95% CI, 0.90-2.39). Conclusions and relevance: Mistreatment is a common experience for LGBTQ+ surgery residents, with attending surgeons being the most common overall source. Increased suicidality among LGBTQ+ surgery residents is associated with this mistreatment. Multifaceted interventions are necessary to develop safer and more inclusive learning environments.Item Giving Virtuous People the License to Harass: The Role of Responsibility-Focused Power Embodiment and Moral Licensing on Sexual Harassment Perceptions(2021-05) Mikalouski, Laurel; Stockdale, Margaret S.; Andel, Stephanie; Pietri, EvavaWhen the #MeToo movement hit its height, many of the powerful figures who were accused of harassment were people who had been previously seen as virtuous (Stockdale, Bell, Crosby, & Berdahl, 2019). The present study investigated how embodied power influenced sexual harassment (SH) judgments by manipulating the initiator to embody responsibility-focused, or self-focused power (compared to a control), and whether moral licensing, operationalized through moral crediting and moral credentialing, would mediate relations between power embodiment and SH judgments. Participants were 376 adults (42% female) residing in the U.S. who were recruited through Mturk. Moral crediting was significantly higher for perpetrators described as embodying responsibility-focused power, compared to a control condition (no power cues), which in turn was higher than perpetrators described as embodying self-focused power. Moral crediting was positively related to false accusations, SH severity (opposite of predictions), and severity of punishment. Additionally, there were gender differences in moral crediting such that the effects of power-embodiment on moral crediting were stronger for women than for men, though both were significant. Taken together, the findings of this study indicate that some initiators evade censure as their actions are seen as less severe when others believe them to have embodies responsibility-focused power. This should serve as an indication that SH is not always done by “bad actors”, but by those who appear to be virtuous. These findings should inform future SH policies, research, and training.Item Patchwork Protections: Progress and Problems in Battling Sexual Orientation Discrimination in Employment(Industrial Organizational Psychologist, 2008) Stockdale, Margaret S.Item Pervasiveness and Impact of Single-Day Episodes of Harassment, Microaggression, and Incivility of Biomedical Health Trainees(Department of Psychology, Indiana University-Purdue University Indianapolis, 2023-07-01) Stockdale, Margaret S.; Kimble-Hill, Ann C.; Dinh, Tuyen K.; Mosier, Amanda E.; Washington, Darius; Wu, Wei; Roper, RandallThe biomedical workforce needs the talents and insights of people from all cross-sections of identity to advance scientific discovery and to improve research application. To build and sustain this workforce, trainees must be treated with respect and support. We assessed the prevalence of daily experiences of harassment, racial mistreatment, and incivility by conducting a national survey of NIH funded graduate students (n=249) and post-doctoral fellows (n=148). Our findings suggest there is an alarming prevalence of mistreatment within research training environments. Our random sampling of F30, F31, F32, and K99 recipients suggests that as many as 45% of graduate students and postdoctoral trainees experience or observe at least one form of mistreatment on any given day, with incivility being the most reported experience. Furthermore, we found that mistreatment experiences and observations were significantly associated with negative program attitudes, indicating a potential risk for attrition among trainees. Moreover, the prevalence of mistreatment was consistent across gender and racial identities. These findings underscore the urgent need for interventions to address mistreatment in research training environments. This study is the first to report empirical data from the trainee perspective on the prevalence and impact of single-day mistreatment in biomedically relevant training programs. Our research is important for understanding the underpinnings of the mentor-mentee and peer-peer interactions responsible for the prevalence of negative environments, as well as highlighting where interventions are necessary to develop supportive leadership and lab culture practices that will improve career outcomes for participants in these fields.Item Power and sex-based harassment among LGBQs(2022-01-01) Dinh, Tuyen K.; Stockdale, Margaret S.Abstract Much of the sex-based harassment (SBH) literature to date focuses on the experiences of heterosexual White women (Brassel et al., 2020). Hence, researchers attempting to understand the motivation of perpetrators of such incidences are often from heterosexual samples, where men harass women to maintain or gain power (e.g., Berdahl, 2007). This leads to the absence of perspectives from historically oppressed groups, such as lesbian, gay, bisexual, or queer (LGBQ) identifying persons. In this paper, we seek to further understand whether power, which is often conceptualized as a key antecedent to sex-based harassment, is also a motivating factor among LGBQ persons. The purpose of this study was to examine two forms of power (egocentric vs responsibility) on increasing sex-based harassment tendencies through feeling states evoked by their respective power types. Results indicate that power effects sex-based harassment tendencies in similar ways as found in heterosexual samples. Specifically, egocentric and responsibility focused power increased SBH through sexy-powerful feelings, moderated by trait dominance, and responsibility-focused power increased SBH through communal feelings. These data provide support for generalizing a theory of SBH intentions to LGBQ populations and we provide recommendations for HR managers.Item Prevalence of Discrimination, Abuse, and Harassment in Emergency Medicine Residency Training in the US(American Medical Association, 2021-08-02) Lall, Michelle D.; Bilimoria, Karl Y.; Lu, Dave W.; Zhan, Tiannan; Barton, Melissa A.; Hu, Yue-Yung; Beeson, Michael S.; Adams, James G.; Nelson, Lewis S.; Baren, Jill M.; Surgery, School of MedicineImportance: The prevalence of workplace mistreatment and its association with the well-being of emergency medicine (EM) residents is unclear. More information about the sources of mistreatment might encourage residency leadership to develop and implement more effective strategies to improve professional well-being not only during residency but also throughout the physician's career. Objective: To examine the prevalence, types, and sources of perceived workplace mistreatment during training among EM residents in the US and the association between mistreatment and suicidal ideation. Design, setting, and participants: In this survey study conducted from February 25 to 29, 2020, all residents enrolled in EM residencies accredited by the Accreditation Council for Graduate Medical Education (ACGME) who participated in the 2020 American Board of Emergency Medicine computer-based In-training Examination were invited to participate. A multiple-choice, 35-item survey was administered after the examination asking residents to self-report the frequency, sources, and types of mistreatment experienced during residency training and whether they had suicidal thoughts. Main outcomes and measures: The types and frequency of workplace mistreatment and the sources of the mistreatment were identified, and rates of self-reported suicidality were obtained. Multivariable logistic regression models were used to examine resident and program characteristics associated with suicidal thoughts. Results: Of 8162 eligible EM residents, 7680 (94.1%) responded to at least 1 question on the survey; 6503 (79.7%) completed the survey in its entirety. A total of 243 ACGME-accredited residency programs participated, and 1 did not. The study cohort included 4768 male residents (62.1%), 2698 female residents (35.1%), 4919 non-Hispanic White residents (64.0%), 2620 residents from other racial/ethnic groups (Alaska Native, American Indian, Asian or Pacific Islander, African American, Mexican American, Native Hawaiian, Puerto Rican, other Hispanic, or mixed or other race) (34.1%), 483 residents who identified as lesbian, gay, bisexual, transgender, queer, or other (LGBTQ+) (6.3%), and 5951 residents who were married or in a relationship (77.5%). Of the total participants, 3463 (45.1%) reported exposure to some type of workplace mistreatment (eg, discrimination, abuse, or harassment) during the most recent academic year. A frequent source of mistreatment was identified as patients and/or patients' families; 1234 respondents (58.7%) reported gender discrimination, 867 (67.5%) racial discrimination, 282 (85.2%) physical abuse, and 723 (69.1%) sexual harassment from patients and/or family members. Suicidal thoughts occurring during the past year were reported by 178 residents (2.5%), with similar prevalence by gender (108 men [2.4%]; 59 women [2.4%]) and race/ethnicity (113 non-Hispanic White residents [2.4%]; 65 residents from other racial/ethnic groups [2.7%]). Conclusions and relevance: In this survey study, EM residents reported that workplace mistreatment occurred frequently. The findings suggest common sources of mistreatment for which educational interventions may be developed to help ensure resident wellness and career satisfaction.Item The Sex-Based Harassment Inventory: A Gender Status Threat Measure of Sex-Based Harassment Intentions(Springer, 2022-05-30) Grabowski, Matthew; Dinh, Tuyen K.; Wu, Wei; Stockdale, Margaret S.We introduce a new inventory measuring sex-based harassment intentions and threat perceptions grounded in gender status threat theories (Berdahl, 2007; Stephan et al., 2016). In Study 1 (N = 568 men), an initial Sex-Based Harassment Inventory (SBHI) was developed with 12 scenarios depicting gender status threats to which respondents rated the likelihood to engage in gender harassment, unwanted sexual attention, supportive conduct, and their perceptions of threat. The final version of the SBHI contained six scenarios with four items each. Gender harassment and unwanted sexual attention intentions loaded on a single, reliable factor, labeled harassment intentions. Two other factors measured threat perceptions and supportive behavior intentions. harassment intentions correlated significantly with threat perceptions, likelihood to sexually harass (Pryor, 1987), hostile and benevolent sexism (Glick & Fiske, 1996), and masculine identification (Glick et al., 2015). In Study 2 (N = 391 men), a non-threat version of the SBHI was compared to the threat version. Threat perceptions mediated the effect of scenario version on harassment intentions, which was stronger at moderate to high levels of hostile sexism and social dominance orientation. Thus, the final version of the SBHI presents promising initial evidence linking sex-based harassment intentions to gender status threat, consistent with Berdahl’s (2007) theory.Item Situating Sexual Harassment in the Broader Context of Interpersonal Violence: Research, Theory, and Policy Implications(Social Issues and Policy Review, 2012-03-05) Stockdale, Margaret S.; Nadler, Joel T.Although sexual harassment has been discussed as a form of interpersonal violence, little research has systematically examined both the empirical and theoretical links between sexual harassment and interpersonal violence. We review survey research data that establishes sexual harassment as a form of revictimization from earlier instances of interpersonal violence, such as child sexual abuse and intimate partner violence as well as ways that sexual harassment and interpersonal violence can mutually co‐occur, such as from dissolved workplace romances or as an escalation from one form of violence to another. Bronfrenbrenner's and Grauerholz's ecological frameworks for understanding interpersonal violence and revictimization from several levels of analysis are invoked to understand the many ways that sexual harassment and interpersonal violence are linked. We further discuss organizational theories of sexual harassment and Routine Activities Theory as frameworks for guiding research in these areas. The review pays particular attention to surveys of multiple forms of sexual victimization, including sexual harassment, documented by the U.S. Military as well as the Military's efforts to comprehensively address these problems.Item When “Good People” Sexually Harass: The Role of Power and Moral Licensing on Sexual Harassment Perceptions and Intentions(Springer, 2022-06-01) Dinh, Tuyen K.; Mikalouski, Laurel; Stockdale, Margaret S.History has shown that people who embody responsibility-focused power have been credibly accused of sexual harassment. Drawing from power-approach and moral licensing theories, we present two complementary studies examining how responsibility-focused power triggers moral licensing, which, in turn, decreases perceptions of sexual harassment (Study 1) and increases intentions to engage in sexual harassment (Study 2). In Study 1, 365 participants read a scenario of a man embodying responsibility-focused power, self-focused power, or low power (control) and then read a case about the man’s alleged sexual harassment against a subordinate. Findings illustrated that moral crediting mediated the effect of power construal on false accusation judgments. In Study 2, 250 participants were primed to experience responsibility-focused power or low power. Responsibility-focused power increased sexual harassment intentions through effects on communal feelings and moral crediting. Based on these findings, we develop a new theoretical perspective on why sexual harassment occurs and why people deny perceiving it. We provide practical recommendations to organizational leaders for developing interventions, such as training, that may disrupt effects of power and moral licensing on sexual harassment intentions, and we encourage public discourse on the harms of harassment that supposed “good people” commit.