Training Neurology Residents to Address Uncomfortable Patient Behavior Through a Simulated Experience
Sakinah Sabadia1, Arielle Kurzweil1, Kaitlyn Lillemoe1, Ariane Lewis1, Perrin Pleninger1, Brandon Giglio1, Mordechai Smith1, Elina Zakin1, Sondra Zabar2
1Department of Neurology, 2Department of Medicine, NYU Langone Medical Center
Objective:
Evaluate how Neurology residents address a complaint of sexual harassment with a patient as the perpetrator.
Background:

Sexual harassment of medical providers is common. While hospitals typically have policies regarding harassment between employees, when the aggressor is a patient, the policies are not always clearly defined. Thus, clinicians may not have guidance on how to address inappropriate behavior from patients.

Design/Methods:

We developed an objective structured clinical examination (OSCE) in our simulation center for graduating Neurology residents. We trained a standardized professional (SP) to act as a junior resident who experienced verbal sexual harassment from a male patient. The learners were asked to elicit the complaint, provide counseling, and devise a plan. Faculty observers were present behind a one-way mirror glass and provided verbal feedback. The SP also gave verbal and written feedback using a standardized rubric. At the end of the encounter, the learners were provided an anonymous survey (1-5, least-most).

Results:

Fifteen residents participated in the OSCE. The SP gave full credit to all of the residents for their non-verbal communication and appropriate acknowledgement of her feelings. Six learners were given partial credit for mitigating the SP’s feeling of isolation. All but three learners were given full credit for collaborating with the SP to formulate a plan to treat the patient.

Eight residents filled out a post-OSCE survey. On average, the learners were moderately prepared for the station (mean score 3.6±1.06), however they did find it to be very useful (mean score 4.5±0.76). All learners who filled out the survey felt that this OSCE should be repeated for future residents.

Conclusions:

OSCEs are a valuable and effective tool to assess how residents support a colleague when patients exhibit inappropriate behavior. This OSCE can be repeated for future residents to assess for trends in performance and perception.

10.1212/WNL.0000000000202572