Workplace Harassment, Cyber Incivility, and Climate in Academic Medicine

Abstract

ImportanceThe culture of academic medicine may foster mistreatment that disproportionately affects individuals who have been marginalized within a given society (minoritized groups) and compromises workforce vitality. Existing research has been limited by a lack of comprehensive, validated measures, low response rates, and narrow samples as well as comparisons limited to the binary gender categories of male or female assigned at birth (cisgender).ObjectiveTo evaluate academic medical culture, faculty mental health, and their relationship.Design, Setting, and ParticipantsA total of 830 faculty members in the US received National Institutes of Health career development awards from 2006-2009, remained in academia, and responded to a 2021 survey that had a response rate of 64%. Experiences were compared by gender, race and ethnicity (using the categories of Asian, underrepresented in medicine [defined as race and ethnicity other than Asian or non-Hispanic White], and White), and lesbian, gay, bisexual, transgender, queer (LGBTQ+) status. Multivariable models were used to explore associations between experiences of culture (climate, sexual harassment, and cyber incivility) with mental health.ExposuresMinoritized identity based on gender, race and ethnicity, and LGBTQ+ status.Main Outcomes and MeasuresThree aspects of culture were measured as the primary outcomes: organizational climate, sexual harassment, and cyber incivility using previously developed instruments. The 5-item Mental Health Inventory (scored from 0 to 100 points with higher values indicating better mental health) was used to evaluate the secondary outcome of mental health.ResultsOf the 830 faculty members, there were 422 men, 385 women, 2 in nonbinary gender category, and 21 who did not identify gender; there were 169 Asian respondents, 66 respondents underrepresented in medicine, 572 White respondents, and 23 respondents who did not report their race and ethnicity; and there were 774 respondents who identified as cisgender and heterosexual, 31 as having LGBTQ+ status, and 25 who did not identify status. Women rated general climate (5-point scale) more negatively than men (mean, 3.68 [95% CI, 3.59-3.77] vs 3.96 [95% CI, 3.88-4.04], respectively, P < .001). Diversity climate ratings differed significantly by gender (mean, 3.72 [95% CI, 3.64-3.80] for women vs 4.16 [95% CI, 4.09-4.23] for men, P < .001) and by race and ethnicity (mean, 4.0 [95% CI, 3.88-4.12] for Asian respondents, 3.71 [95% CI, 3.50-3.92] for respondents underrepresented in medicine, and 3.96 [95% CI, 3.90-4.02] for White respondents, P = .04). Women were more likely than men to report experiencing gender harassment (sexist remarks and crude behaviors) (71.9% [95% CI, 67.1%-76.4%] vs 44.9% [95% CI, 40.1%-49.8%], respectively, P < .001). Respondents with LGBTQ+ status were more likely to report experiencing sexual harassment than cisgender and heterosexual respondents when using social media professionally (13.3% [95% CI, 1.7%-40.5%] vs 2.5% [95% CI, 1.2%-4.6%], respectively, P = .01). Each of the 3 aspects of culture and gender were significantly associated with the secondary outcome of mental health in the multivariable analysis.Conclusions and RelevanceHigh rates of sexual harassment, cyber incivility, and negative organizational climate exist in academic medicine, disproportionately affecting minoritized groups and affecting mental health. Ongoing efforts to transform culture are necessary.

Gender Differences in Faculty Perceptions of Mentorship and Sponsorship

“…Of 1430 individuals surveyed, 915 responded (64.0%); respondents did not differ significantly from nonrespondents by gender . The analytic sample was restricted to respondents remaining in academia (830 [90.7%]) and, for gender comparisons, to those identifying as men (422 [50.8%]) or women (385 [46.4%]).…”

Development of a Tool to Measure Student Perceptions of Equity and Inclusion in Medical Schools

“…Nevertheless, prior research has shown that small differences between groups, even with small effect sizes, can accumulate over time and have substantial influence on real world outcomes . Moreover, the size of differences between groups are similar to results found in other climate surveys used by the AAMC and in prior national studies . Future studies of the tool will examine how differences in tool scores influence disparities in consequential student outcomes in the learning environment, including attrition, successful placement into graduate medical education, burnout, and the receipt of academic awards.…”

Professional Experiences and Career Trajectories of Mid- to Senior-Career Women Clinician-Scientists

“…The data reported here are part of an ongoing longitudinal study of clinician-scientists who received National Institutes of Health (NIH) K08 or K23 career development awards between 2006 and 2009 . We surveyed individuals 3 times, most recently in 2021 …”