PREVALENCE

Sexual harassment is defined by the U.S. Equal Employment Opportunity Commission as, "unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature," that, "explicitly or implicitly affects an individual's employment, unreasonably interferes with an individual's work performance, or creates an intimidating, hostile, or offensive work environment" (EEOC, https://www.eeoc.gov/eeoc/publications/fs-sex.cfm). A national survey of mostly female ophthalmologists and ophthalmology trainees showed that 59% had experienced sexual harassment during their careers, most commonly during training [1]. Of the ophthalmologists who reported experiencing sexual harassment, 45% had been harassed by patients [1]. Few had reported their most significant experience with sexual harassment to an authority [1].

IMPORTANCE

• Exposure to sexual harassment among medical trainees has been associated with increased rates of depression, anxiety, insomnia, and post-traumatic stress disorder [2].
• Among women ophthalmologists who had experienced sexual harassment, 87% reported significant impacts on their professional lives, including interference with their ability to work [1].
• Institutional sexual harassment training often focuses on harassment initiated by supervisors or workers, and guidelines on responding to sexual harassment initiated by patients and families are sparse [3].
• Sexual harassment affects all members of a clinical team when it negatively impacts a physician's ability to provide excellent patient care.

TOOLS FOR RESPONDING

The Toolkit for Responding to Patient-Initiated Verbal Sexual Harassment was created in 2019 as part of a training program for ophthalmology faculty and trainees. It is meant to supplement existing sexual harassment training curricula. Toolkit strategies are designed for responding to patient-initiated verbal sexual harassment, but may be applied to other forms of mistreatment, including harassment based on race, age, or sexual orientation. If one decides to respond to patient-initiated verbal sexual harassment, generally a non-confrontational, non-judgmental tone is preferred [4].

Click here to download toolkit

View MedEdPORTAL curriculum for full workshop materials

References

1. Cabrera MT, Enyedi LB, Ding L, MacDonald SM. Sexual Harassment in Ophthalmology: A Survey Study. Ophthalmology 2019;126(1):172-174.  https://PubMed.gov/30340768. DOI: 10.1016/j.ophtha.2018.09.016
2. Fnais N, Soobiah C, Chen MH, Lillie E, Perrier L, Tashkhandi M, Straus SE, Mamdani M, Al-Omran M, Tricco AC. Harassment and discrimination in medical training: a systematic review and meta-analysis. Acad Med 2014;89(5):817-827.  https://PubMed.gov/24667512. DOI: 10.1097/ACM.0000000000000200
3. Warsame RM, Hayes SN. Mayo Clinic's 5-Step Policy for Responding to Bias Incidents. AMA J Ethics 2019;21(6):E521-529.  https://PubMed.gov/31204993. DOI: 10.1001/amajethics.2019.521
4. Goodman DJ. Responding to biased or offensive comments. Promoting Diversity and Social Justice: Educating People from Privileged Groups. New York: Routledge; 2011.

Suggested Citation Format

Hock LE, Scruggs BA, Oetting TA, Abramoff MD, Shriver EM. Tools for Responding to Patient-Initiated Verbal Sexual Harassment. EyeRounds.org. Posted August 20, 2019; Available from https://EyeRounds.org/tutorials/sexual-harassment-toolkit/index.htm