Acoso laboral en residentes de cirugía: antecedentes, consecuencias y estrategias de intervención
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https://doi.org/10.30944/20117582.2665Palabras clave:
acoso escolar, acoso sexual, estrés laboral, educación de postgrado en medicina, cirugía generalResumen
Introducción. El acoso laboral es un problema mayor en la educación quirúrgica, sin embargo, la información sobre su conceptualización, a partir de fundamentos teóricos y evidencia empírica, es limitada.
Métodos. Se realizó una revisión narrativa sobre el acoso laboral en residentes de cirugía para explorar sus antecedentes, desenlaces y estrategias de mitigación, con base en perspectivas organizacionales y evidencia empírica disponible.
Resultados. El acoso laboral se refiere a comportamientos negativos y hostiles, deliberados e intencionales, repetitivos, que producen daño en el otro, y generan consecuencias negativas para el desempeño individual y organizacional. Sus principales precursores se encuentran en la pobre cultura educativa de los departamentos quirúrgicos. El acoso laboral afecta negativamente residentes, pacientes, organizaciones y sistemas sanitarios. Existen estrategias organizacionales enfocadas en la prevención primaria, secundaria y terciaria, que pueden contribuir a mitigar el problema.
Conclusión. El acoso laboral es un problema complejo que afecta la educación de los cirujanos. Existen precursores específicos que pueden ser modificados a través de estrategias multidimensionales. Los vacíos en la evidencia al respecto de este tema ofrecen oportunidades de investigación futura.
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Referencias bibliográficas
Einarsen SV, Hoel H, Zapf D, Cooper C. The Concept of bullying and harassment at work. En: Bullying and harassment in the workplace. Developments in theory, research, and practice. Second Edition; Boca Raton: CRC Press; 2010. p. 3-39. https://doi.org/10.1201/EBK1439804896
Duffy M, Sperry L. Mobbing: Causes, consequences, and solutions. Oxford University Press; 2012. https://doi.org/10.1093/acprof:oso/9780195380019.001.0001
Yamada DC, Duffy M, Berry PA. Workplace bullying and mobbing: Definitions, terms, and when they matter. En: Duffy M, Yamada DC, eds. Workplace bullying and mobbing in the United States. Santa Barbara: Praeger; 2018. Vol 1. p. 3-24.
Keashly L, Jagatic K. By any other name: American perspectives on workplace bullying. En: Bullying and harassment in the workplace. Developments in theory, research, and practice. Second Edition; Boca Raton: CRC Press; 2010. p. 41-61. https://doi.org/10.1201/EBK1439804896
Davenport N, Schwartz RD, Elliott GP. Mobbing: Emotional abuse in the American workplace. Ames, Iowa: Civil Society Publishing; 1999. p. 213.
Thomas D, Zairina E, George J. Methodological approaches to literature review. En: Encyclopedia of evidence in pharmaceutical public health and health services research in pharmacy. Cham: Springer; 2023. p. 1-15. https://doi.org/10.1007/978-3-030-50247-8_57-1
White S. An introduction to the psychodynamics of workplace bullying. London: Routledge; 2018. p. 252. https://doi.org/10.4324/978042947173510.4324/9 780429471735
Duffy M, Sperry L. Mobbing is not bullying. En: Overcoming mobbing: A recovery guide of workplace aggression and bullying. Oxford University Press; 2014. p. 1-18.
Jenkins M. Preventing and managing workplace bullying and harassment: A risk management approach. Brisbane: Australian Academic Press; 2013.
Carbo JA. Understanding, defining and eliminating workplace bullying: Assuring dignity at work. London: Routledge; 2017. p. 188. https://doi.org/10.4324/9781315549057
Kelly S. Workplace bullying: The silent epidemic. N Z Med J. 2004;117:U1125.
Álvarez-Villalobos NA, De León-Gutiérrez H, Ruiz-Hernandez FG, Elizondo-Omaña GG, Vaquera-Alfaro HA, Carranza-Guzmán FJ. Prevalence and associated factors of bullying in medical residents: A systematic review and meta-analysis. J Occup Health. 2023;65:e12418. https://doi.org/10.1002/1348-9585.12418
Gianakos AL, Freischlag JA, Mercurio AM, Haring RS, LaPorte DM, Mulcahey MK, et al. Bullying, discrimination, harassment, sexual harassment, and the fear of retaliation during surgical residency training: A systematic review. World J Surg. 2022;46:1587-99. https://doi.org/10.1007/s00268-021-06432-6
Domínguez LC, Torregrosa L, Cuevas L, Peña L, Sánchez S, Pedraza M, et al. Workplace bullying and sexual harassment among general surgery residents in Colombia. Biomedica. 2023;43:252-60. https://doi.org/10.7705/BIOMEDICA.6915
Domínguez-Torres LC, Sanabria-Quiroga ÁE, Torregrosa-Almonacid L, Vega-Peña NV. Acoso laboral y sexual en residentes de cirugía colombianos en 2023. Rev Colomb Cir. 2024;39:681-90. https://doi.org/10.30944/20117582.2531
Nagata-Kobayashi S, Maeno T, Yoshizu M, Shimbo T. Universal problems during residency: Abuse and harassment. Med Educ. 2009;43:628-36. https://doi.org/10.1111/J.1365-2923.2009.03388.X
Sarmiento-Altamirano D, Himmler A, Cabrera-Ordoñez C, Olmedo-Abril S, Biondi A, Di Saverio S. Gender disparities in Ecuador: A survey study of the under-representation of women in surgery. Updates Surg. 2021;73:2009-15. https://doi.org/10.1007/S13304-020-00964-7
Martins RS, Hashmi SA, Inam H, Janjua MBN, Malik MA. Harassment and mental health in surgical training: A pilot survey of surgical trainees in Pakistan. J Pak Med Assoc. 2021;71(Suppl 1):S23-S28.
Crebbin W, Campbell G, Hillis DA, Watters DA. Prevalence of bullying, discrimination and sexual harassment in surgery in Australasia. ANZ J Surg. 2015;85:905-9. https://doi.org/10.1111/ANS.13363
Hu YY, Ellis RJ, Hewitt DB, Yang AD, Cheung EO, Moskowitz JT, et al. Discrimination, abuse, harassment, and burnout in surgical residency training. N Engl J Med. 2019;381:1741-52. https://doi.org/10.1056/NEJMSA1903759
Lucas-Guerrero V, Pascua-Solé M, Ramos Rodríguez JL, Borrás AT, González de Pedro C, Jover Navalón JM, et al. Desgaste profesional o burnout en los residentes de Cirugía General. Encuesta de la Asociación Española de Cirujanos. Cir Esp. 2020;98:442-9. https://doi.org/10.1016/J.CIRESP.2020.04.013
Clements JM, King M, Nicholas R, Burdall O, Elsey E, Bucknall V, et al. Bullying and undermining behaviours in surgery: A qualitative study of surgical trainee experiences in the United Kingdom (UK) & Republic of Ireland (ROI). Int J Surg. 2020;84:219-25. https://doi.org/10.1016/J.IJSU.2020.07.031
Schlitzkus LL, Vogt KN, Sullivan ME, Schenarts KD. Workplace bullying of general surgery residents by nurses. J Surg Educ. 2014;71:e149-e154. https://doi.org/10.1016/j.jsurg.2014.08.003
Abate LE, Greenberg L. Incivility in medical education: A scoping review. BMC Med Educ. 2023;23:24. https://doi.org/10.1186/s12909-022-03988-2
Ling M, Young CJ, Shepherd HL, Mak C, Saw RPM. Workplace bullying in surgery. World J Surg. 2016;40:2560- 6. https://doi.org/10.1007/S00268-016-3642-7
Einarsen S, Hoel H, Notelaers G. Measuring exposure to bullying and harassment at work: Validity, factor structure and psychometric properties of the Negative Acts Questionnaire-Revised. Work Stress. 2009;23:24- 44. https://doi.org/10.1080/02678370902815673
Sarr MG. Bullying of surgery residents and attending staff surgeons is a problem! World J Surg. 2016;40:2567-8. https://doi.org/10.1007/s00268-016-3592-0
El Boghdady M. The development of anti-bullying, discrimination and harassment guidance: A survey among the Association of Surgeons in Training (ASiT) council members. Ann R Coll Surg Engl. 2024;106:364-8. https://doi.org/10.1308/rcsann.2023.0071
Holzgang M, Koenemann N, Skinner H, Burke J, Smith A, Young A. Discrimination in the surgical discipline: An international European evaluation (DISDAIN). BJS Open. 2021;5:zrab050. https://doi.org/10.1093/BJSOPEN/ZRAB050
Pillado EB, Li RD, Eng JS, Chia MC, Conway A, DiLosa K, et al. Defining sources and ramifications of mistreatment among female vascular surgery trainees. J Vasc Surg. 2023;78:797-804. https://doi.org/10.1016/j.jvs.2023.03.504
Enriquez-Estrada VM, Antonio-Villa NE, Bello-Chavolla OY, Cuevas-García CF, Vargas-Gutiérrez PL, Corlay-Noriega ISY, et al. Assessment of psychological terror and its impact on mental health and quality of life in medical residents at a reference medical center in Mexico: A cross-sectional study. PLoS One. 2023;18:e0295138. https://doi.org/10.1371/journal.pone.0295138
van Norman GA. Abusive and disruptive behavior in the surgical team. AMA J Ethics. 2015;17:215-20. https://doi.org/10.1001/journalofethics.2015. 17.3.ecas3-1503
Lazarus JL, Hosseini M, Kamangar F, Levien DH, Rowland PA, Kowdley GC, et al. Verbal aggressiveness among physicians and trainees. J Surg Educ. 2016;73:756-60. https://doi.org/10.1016/j.jsurg.2016.03.005
Brown C, Egan RJ, Lewis W. The hidden curriculum: Requiem for a surgical dream. Postgrad Med J. 2019;95:237-9. https://doi.org/10.1136/postgradmedj-2018-136076
O’Keeffe DA, Brennan SR, Doherty EM. Resident training for successful professional interactions. J Surg Educ. 2022;79:107-11. https://doi.org/10.1016/j.jsurg.2021.08.017
El Boghdady M, Ewalds-Kvist BM. Surgeon’s narcissism, hostility, stress, bullying, meaning in life and work environment: A two-centered analysis. Langenbecks Arch Surg. 2023;408:349. https://doi.org/10.1007/s00423-023-03068-z
Pei KY, Cochran A. Workplace bullying among surgeons - The perfect crime. Ann Surg. 2019;269:43-4. https://doi.org/10.1097/SLA.0000000000003018
Leisy HB, Ahmad M. Altering workplace attitudes for resident education (A.W.A.R.E.): Discovering solutions for medical resident bullying through literature review. BMC Med Educ. 2016;16:127. https://doi.org/10.1186/s12909-016-0639-8
Halim UA, Riding DM. Systematic review of the prevalence, impact and mitigating strategies for bullying, undermining behaviour and harassment in the surgical workplace. Br J Surg. 2018;105:1390-7. https://doi.org/10.1002/bjs.10926
Forel D, Vandepeer M, Duncan J, Tivey DR, Tobin SA. Leaving surgical training: Some of the reasons are in surgery. ANZ J Surg. 2018;88:402-7. https://doi.org/10.1111/ans.14393
Jackson T, Zhou C, Khorgami Z, Jackson D, Agrawal V, Taubman K, et al. Traumatized residents — It’s not surgery. It’s medicine. J Surg Educ. 2019;76:e30-e40. https://doi.org/10.1016/j.jsurg.2019.08.002
Coverdill JE, Bittner JG, Park MA, Pipkin WL, Mellinger JD. Fatigue as impairment or educational necessity? Insights into surgical culture. Acad Med. 2011;86(10 Suppl):S69-72. https://doi.org/10.1097/acm.0b013e31822a6b40
McIlhenny C, Kurashima Y, Chan C, Hirano S, Domínguez-Rosado I, Stefanidis D. General surgery education across three continents. Am J Surg. 2018;215:209-13. https://doi.org/10.1016/j.amjsurg.2017.12.002
Liang R, Anthony A, Leditschke IA. Five myths about unacceptable behaviour in surgical education. ANZ J Surg. 2020;90:965-9. https://doi.org/10.1111/ans.15756
Naterwala T, Chia MC, Khorfan R, Cheung EO, Eng JS, Hu YY, et al. Associations between program doximity reputation rank and well-being in general surgery residents. J Surg Res. 2024;296:597-602. https://doi.org/10.1016/j.jss.2024.01.036
Kamali D, Illing J. How can positive and negative trainer feedback in the operating theatre impact a surgical trainee’s confidence and well-being: A qualitative study in the north of England. BMJ Open. 2018;8:e017935. https://doi.org/10.1136/bmjopen-2017-017935
Gretton-Watson P, Oakman J, Leggat SG. What is the nature, extent and impact of bullying in surgical settings? Insights of surgeons in Australia and Aotearoa New Zealand. ANZ J Surg. 2024;94:24-9. https://doi.org/10.1111/ans.18661
Jackson T, Provencio A, Bentley-Kumar K, Pearcy C, Cook T, McLean K, et al. PTSD and surgical residents: Everybody hurts… sometimes. Am J Surg. 2017;214:1118-24. https://doi.org/10.1016/J.AMJSURG.2017.08.037
Gutiérrez-Cirlos C, Naveja-Romero J de J, Leenen I, Sánchez-Mendiola M. Factores relacionados con la elección de una especialidad en médicos residentes mexicanos. Gac Med Mex. 2017;153:800-9. https://doi.org/10.24875/GMM.17002959
Domínguez LC, Sanabria ÁE, Vega NV, Espitia EL, Cabrera EY, Osorio C. Factores que influencian la elección de una carrera quirúrgica: Análisis multiinstitucional global desde una perspectiva académica en Bogotá. Rev Colomb Cir. 2013;28:275-81. https://doi.org/10.30944/20117582.347
Liang R, Dornan T, Nestel D. Why do women leave surgical training? A qualitative and feminist study. Lancet. 2019;393:541-9. https://doi.org/10.1016/s0140-6736(18)32612-6
Domínguez-Torres LC. Persistence in surgical training: The role of job crafting and leadership. Doctoral Thesis. Maastricht: Ipskamp Printing BV; 2022. https://doi.org/10.26481/DIS.20210223LD
Villafranca A, Hamlin C, Enns S, Jacobsohn E. Disruptive behaviour in the perioperative setting: a contemporary review. Can J Anaesth. 2017;64:128-40. https://doi.org/10.1007/s12630-016-0784-x
Branch S, Caponecchia C, Murray JP. Strengthening the evidence base of workplace bullying interventions through prevention and implementation research. En: D’Cruz P, Noronha E, Caponecchia C, Escartín J, Salin D, Tuckey MR, eds. Dignity and inclusion at work. Handbooks of workplace bullying, emotional abuse and harassment. Vol 3. Singapore: Springer; 2021. p. 293- 328. https://doi.org/10.1007/978-981-13-0218-3_10
Vartia M, Leka S. Interventions for the prevention and management of bullying at work. En: Bullying and harassment in the workplace. Developments in theory, research, and practice. Second Edition; Boca Raton: CRC Press; 2010. p. 157-379. https://doi.org/10.1201/EBK1439804896
Escartín J. Insights into workplace bullying: Psychosocial drivers and effective interventions. Psychol Res Behav Manag. 2016;9:157-69. https://doi.org/10.2147/PRBM.S91211
Wild JRL, Ferguson HJM, McDermott FD, Hornby ST, Gokani VJ; Council of the Association of Surgeons in Training. Undermining and bullying in surgical training: A review and recommendations by the Association of Surgeons in Training. Int J Surg. 2015;23(Suppl 1):S5-S9. https://doi.org/10.1016/J.IJSU.2015.09.017
Domínguez LC, Dolmans D, Restrepo J, de Grave W, Sanabria A, Stassen L. How surgical leaders transform their residents to craft their jobs: surgeons’ perspective. J Surg Res. 2021;265:233-44. https://doi.org/10.1016/j.jss.2021.03.034
Dominguez LC, Dolmans D, de Grave W, Donkers J, Sanabria A, Stassen L. Supervisors’ transformational leadership style and residents’ job crafting in surgical training: The residents’ views. Int J Med Educ. 2022;13:74-83. https://doi.org/10.5116/IJME.622D.E2F6
Castillo-Angeles M, Calvillo-Ortiz R, Acosta D, Watkins AA, Evenson A, Atkins KM, et al. Mistreatment and the learning environment: A mixed methods approach to assess knowledge and raise awareness amongst residents. J Surg Educ. 2019;76:305-14. https://doi.org/10.1016/j.jsurg.2018.07.019
Fisher RJ. Assessing the contingency model of third-party intervention in successful cases of prenegotiation. J Peace Res. 2007;44:311-29. https://doi.org/10.1177/0022343307076638
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