Maintaining Personal Safety: Understanding and Addressing Aggression and Violence in the Health Care Setting

A 2-hour introductory lecture-discussion curriculum was developed to provide medical students and residents with education about personal safety in the health care setting. The course focused on providing learners with proactive and practical advice for understanding, recognizing, and responding to difficult patients or others who may pose risks of violence. It was designed for participants to gain knowledge about initial management of often unfamiliar situations before untoward behaviors escalate to violence.

Eight hundred thirty-eight medical students participated in this required element of the third-year psychiatry clerkship experience. Sixty first-year through fourth-year psychiatry residents participated as part of departmental orientation. Instructors provided the same seminar for both learner groups throughout the project's duration. In addition to a PowerPoint presentation, learners participated in discussion about personal safety threats in the health care setting. Evaluations were obtained, and more recent cohorts also completed a postcourse assessment of knowledge.

Results suggested that learners from both groups viewed the session favorably, indicating the personal safety curriculum was beneficial and practical and helped increase their knowledge about this important topic. The session received a high number of positive comments from learners, reinforcing its valuable take-home message.

Given the growing magnitude and understanding of risk of aggression and violence in health care settings, we incorporated a required personal safety session into our psychiatry residency and medical school curricula. The session's emphasis was on preventative and proactive strategies to employ with patients before and during escalation of potentially violent situations.