A U.S. Survey of Sexual Harassment in Ophthalmology Training Using a Novel Standardized Scale

Abstract

Objective This study aimed to assess the frequency and severity of sexual harassment toward ophthalmology trainees.

Design Present study is an anonymous retrospective online survey.

Participants U.S. ophthalmology residents and fellows participated in this study.

Methods Sexual harassment comments directed toward University of Iowa ophthalmology trainees and faculty members were compiled. Statements were ranked by severity to develop the Iowa Verbal Sexual Harassment Scale. A brief, anonymous online survey incorporating the scale was sent to all United States ophthalmology residency program directors to distribute among trainees. Participants rated the prevalence, severity, and frequency of verbal and physical sexual harassment during training.

Main Outcome Measures Response to the survey questions on the prevalence, severity, and frequency of reporting of verbal and physical sexual harassment in ophthalmology training.

Results Among 112 respondents (59 men and 53 women), 72 (64.3%) experienced sexual harassment in the workplace from patients (86.8% of women vs. 44.1% of men; p < 0.0001, 95% confidence interval [CI]: 1.48–2.74). Trainees rarely experienced harassment by colleagues (10.7%) or supervisors (8.9%). Women experienced more severe and frequent sexual harassment compared with men, with 54.7% women and 30.5% men experiencing sexual harassment weekly (p = 0.013, 95% CI: 1.29–5.71). Unwanted touching was the most common physical harassment type. The trainees' threshold for reporting sexual harassment was higher than their worst actual experience (p< 0.0001, F(2,282) = 67.59). Few trainees formally reported verbal (6.3%) or physical sexual harassment (1.8%). Trainees most commonly responded to harassment by redirecting the harasser (67.9%). Only 33.9% of trainees rated their institution's sexual harassment training as helpful preparation for addressing harassment.

Conclusion Most ophthalmology trainees experienced sexual harassment with almost all harassment coming from patients. Female trainees reported substantially greater severity and frequency of sexual harassment. There remains an unmet need for targeted response training in ophthalmology training programs.

Keywords

ophthalmology training - residency - fellowship - sexual harassment

• References

• 1 Jagsi R, Griffith KA, Jones R, Perumalswami CR, Ubel P, Stewart A. Sexual harassment and discrimination experiences of academic medical faculty. JAMA 2016; 315 (19) 2120-2121
• 2 Jagsi R. Sexual harassment in medicine - #MeToo. N Engl J Med 2018; 378 (03) 209-211
• 3 Cabrera MT, Enyedi LB, Ding L, MacDonald SM. Sexual harassment in ophthalmology: a survey study. Ophthalmology 2019; 126 (01) 172-174
• 4 Lui PP, Quezada L. Associations between microaggression and adjustment outcomes: a meta-analytic and narrative review. Psychol Bull 2019; 145 (01) 45-78
• 5 Thurston RC, Chang Y, Matthews KA, von Känel R, Koenen K. Association of sexual harassment and sexual assault with midlife women's mental and physical health. JAMA Intern Med 2019; 179 (01) 48-53
• 6 Till FJ. Sexual Harassment. A Report on the Sexual Harassment of Students. Washington, D.C.: National Advisory Council on Women's Educational Programs; 1980
• 7 Preventing Sexual Harassment. The U.S. Equal Employment Opportunity Commission Manual, BNA Communications, Inc. SDC IP.73; 1992
• 8 Fnais N, Soobiah C, Chen MH. , et al. Harassment and discrimination in medical training: a systematic review and meta-analysis. Acad Med 2014; 89 (05) 817-827
• 9 Cambier Z, Boissonnault JS, Hetzel SJ, Plack MM. Physical therapist, physical therapist assistant, and student response to inappropriate patient sexual behavior: results of a national survey. Phys Ther 2018; 98 (09) 804-814