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Updated: Apr 6, 2026

The Resident-intruder Paradigm: A Standardized Test for Aggression, Violence and Social Stress
Published on: July 4, 2013
Residents in distress: an exploration of assistance-seeking and reporting behaviors
Hilary Sanfey1, John A Fromson2, John Mellinger1
1Department of Surgery, Southern Illinois School of Medicine, PO Box 19638, Springfield, IL 62794, USA.
Background:
This study explores assistance-seeking and reporting behaviors in surgical residents faced with stressful circumstances.
Methods:
Three surgical societies distributed a multiple choice, free-text response survey to residents.
Results:
One hundred sixty-four residents (39% male) responded; 58% of women (43% men) were married; and 22% of men (7% women) were international medical graduates. Residents' dominant action to colleagues' concerning behavior was to approach him/her directly. Women were more likely to report colleagues' unpredictable behavior toward staff (28% vs 10%, P < .05), alcohol on breath at work (53% vs 32%, P = nonsignificant), and personal hygiene deterioration (15% vs 2%, P < .05) to an authority. Men were more likely to ignore frequent interpersonal conflicts and illnesses.
Conclusions:
Male and female surgery residents adopt different strategies in dealing with perceived distress in their colleagues. These impact their response to signs of impairment. Educators should consider sex while providing residents with an understanding of their role in the recognition of personal impairment and that of their peers.
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