Introduction: Patients are the most common source of gender-based harassment of resident physicians, yet residents receive little training on how to handle it. Few resources exist for residents wishing to address patient-initiated verbal sexual harassment themselves. Methods: We developed, taught, and evaluated a 50-minute workshop to prepare residents and faculty to respond to patient-initiated verbal sexual harassment toward themselves and others. The workshop used an interactive lecture and role-play scenarios to teach a tool kit of communication strategies for responding to harassment. Participants completed retrospective pre-post surveys on their ability to meet the learning objectives and their preparedness to respond. Results: Ninety-one participants (57 trainees, 34 faculty) completed surveys at one of five workshop sessions across multiple departments. Before the workshop, two-thirds (67%) had experienced patient-initiated sexual harassment, and only 28 out of 59 (48%) had ever addressed it. Seventy-five percent of participants had never received training on responding to patient-initiated sexual harassment. After the workshop, participants reported significant improvement in their preparedness to recognize and respond to all forms of patient-initiated verbal sexual harassment (p < .01), with the greatest improvements noted in responding to mild forms of verbal sexual harassment, such as comments on appearance or attractiveness or inappropriate jokes (p < .01). Discussion: This workshop fills a void by preparing residents and faculty to respond to verbal sexual harassment from patients that is not directly observed. Role-play and rehearsal of an individualized response script significantly improved participants' preparedness to respond to harassment toward themselves and others.

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.

Background Sexual harassment of physicians by patients is highly prevalent and rarely reported. Little is known on how to prepare physicians to handle verbal sexual harassment that detracts from their ability to provide care but does not meet the threshold for reporting. Purpose To assess the impact of a sexual harassment workshop and toolkit for ophthalmologists and ophthalmology trainees on responding to patient-initiated verbal sexual harassment. Methods A survey study of ophthalmology faculty, fellows, and residents who participated in workshops on responding to patient-initiated verbal sexual harassment was performed at an academic center. A toolkit of strategies for response was distributed. Volunteer participants completed a retrospective pretest–posttest evaluation at the conclusion of the workshop and follow-up survey 3 weeks after the workshops on whether they experienced harassment and intervened. The pretest–posttest surveys assessed the workshop's effect on ophthalmologists' perceptions of and preparedness to respond to sexual harassment in the moment using a 5-point Likert scale, including bystander intervention. Participants described their responses observing and/or experiencing patient-initiated sexual harassment in the 3 weeks following the workshop and whether they had intervened toward the harassment. Results Ophthalmologists (n = 31) felt significantly more prepared to respond to patient-initiated sexual harassment directed toward themselves or a trainee in the moment after participating in the workshop (4.5 ± 1.63) than before (3.0 ± 1.3) with a mean change of 1.6 (95% confidence interval: 0.98–2.2, p < 0.001). After the workshop, 86.3% of participants felt mostly or completely prepared to respond to comments about their age, gender, marital status, appearance, attractiveness, a specific body part, and sexual or inappropriate jokes. Most participants (83.9%) said that they had not previously received training on techniques for responding to patient-initiated sexual harassment. Two-thirds (66.7%) of participants who experienced (n = 8) or observed (n = 13) harassment (n = 15) following the workshop intervened. All participants who intervened toward patient-initiated harassment behavior after the workshop (n = 10) found the Sexual Harassment Toolkit helpful in addressing harassment in the moment. Conclusion Participation in a brief skills-based workshop significantly improved ophthalmologists' preparedness to respond to verbal sexual harassment by patients.