Differences in the resident encounter of disruptive behavior by gender

Abstract

This study aimed to investigate the prevalence of gender-based differences in disruptive behaviors (DBs) among trainee physicians to shed light on the extent and nature of the problem. Using a national cross-sectional design, data were collected through a web-based, self-administered questionnaire administered to post-graduate first-year (PGY1) and second-year (PGY2) residents participating in the General Medicine Intermittent Examination (GM-ITE). A total of 5,403 participants, representing a response rate of 71.9%, were included in the study. Of these, approximately 35% of residents reported encounters with DBs in the past year. A gender-based comparison revealed that 38.4% of male residents faced DBs from physicians, compared to 27.6% of their female counterparts (p < 0.001). Conversely, a higher proportion of male residents (35.8%) experienced DBs from nurses than did female residents (32.9%; p = 0.037). After adjusting for factors such as hospital size, hospital type, urban location, age, and PGY, male residents exhibited an increased likelihood of experiencing DB from both physicians (adjusted OR 1.59, 95% CI 1.40–1.81) and nurses (adjusted OR 1.17, 95% CI 1.03–1.32) relative to women. Moreover, the study provides valuable insight into the prevalence of various types of DBs experienced by trainee physicians, including disrespectful behavior, exclusion from patient discussions, and reprimands. Understanding and addressing the gender-based differences in DBs among trainee physicians is crucial for improving the educational environment and promoting respectful behavior in healthcare settings. These findings highlight the need for targeted interventions based on gender to mitigate the negative impact of DBs on patient care and the well-being of medical residents.

Keywords:

• Disruptive behavior
• medical resident
• gender difference
• post-graduate clinical training

Disclosure statement

Y.N. received an honorarium from the Japan Institute for Advancement of Medical Education Program (JAMEP) as a GM-ITE project manager. Y.T. is the director of JAMEP; he received an honorarium from JAMEP for delivering lectures for JAMEP. Otherwise, the authors declare that they have no conflict of interest.

Additional information

Funding

This work was supported by the Japan Society for the Promotion of Science [20H03913].

Notes on contributors

Takashi Watari

Takashi Watari, MD, MHQS, PhD, Shimane University Hospital, General Medicine Center, Shimane, Japan. Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.

Virginia Sheffield

Virginia Sheffield, MD, Medicine Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA. Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.

Yuji Nishizaki

Yuji Nishizaki, MD, PhD, Division of Medical Education, Juntendo University School of Medicine, Tokyo, Japan.

Yasuharu Tokuda

Yasuharu Tokuda, MD, MPH, Muribushi Okinawa Project for Teaching Hospitals, Okinawa, Japan.