Preparing Psychiatric Residents for Workplace Violence: Evaluating the Impact of Self-Defense and Situational...

Violence against psychiatric healthcare workers in inpatient units is prevalent and often the result of a series of behaviors exhibited by the attacker while the victim is in a vulnerable position. Therefore, a better understanding of situational awareness, the thought processes with which attackers engage, and the importance of mental and physical readiness may reduce the number and severity of attacks and better prepare residents and other workers for this threat.

All residents enrolled in the psychiatry residency program (N = 27) from March to May 2021 were invited to participate in a study evaluating their perceptions of violence and confidence in managing it during their inpatient psychiatric rotations. A total of 22 residents responded (response rates were 66.7% pretraining and 81.5% posttraining). Participants completed surveys at three time points: immediately before, 1 week after, and 1 month after completing 3-hour proactive, hands-on, self-defense training.

Residents had realistic expectations about exposure to violence, with 43% expressing concern about their rotation due to fear of violence. However, only 14% felt this fear negatively affected their performance. While most residents felt underprepared to manage violence in healthcare settings, 90% reported that the training improved their confidence. Self-assurance also increased significantly, rising from 38% before the course to 83% after completion.

Incorporating comprehensive hands-on training into the psychiatry residency curriculum can significantly enhance residents' confidence and ability to manage potentially violent encounters. This training, modeled after protocols used by law enforcement and conducted by a former police officer, should be further researched in various hospital-based settings and populations to evaluate its broader impact.