“Not a Woman-Question, But a Power-Question”: A Qualitative Study of Third Parties on Psychological Violence in Academic Medicine

BACKGROUND: Psychological violence is a persistent issue in academic medicine and affects the health and safety of health care workers. This violence is also debated as part of medical culture. Third parties, persons learning about violations after it happened, may provide an understanding of the interplay between gender and psychological violence. Perspectives on research on psychological violence in academic medicine are currently lacking. METHODS: In this qualitative exploratory study, interviews were conducted with women from a working group on equal treatment at one medical university in Austria. This group monitors discrimination and harassment and consists of medical doctors, natural scientists, administrative staff, and students. To recruit participants, an email invitation was sent to members of the working group. Of 20 eligible persons, 12 women participated. After written consent from participants, individual interviews were conducted face-to-face, audio-recorded, and transcribed verbatim. Data were analyzed with grounded theory. FINDINGS: Participants described a firm organizational culture with persistent, historically grown gendered structures. Potential threat of psychological violence affected mostly “weaker,” less powerful persons, and often women. Descriptions of violence indicated harm to those affected, but intent to harm was doubted. Interventions strengthened the individual, but some participants demanded collective responsibility. CONCLUSION/APPLICATION TO PRACTICE: Few descriptions could be classified as psychological violence. Findings indicated a need to change organizational cultures where lower positions pose a potential threat to experiencing harm. Occupational health practice should include training in sensitization to psychological violence, protection of those targeted, deconstructing power accumulation, and promoting diversity in career patterns and working styles.