Introduction: Several studies have shown that workplace violence in the emergency department (ED) iscommon. Residents may be among the most vulnerable staff, as they have the least experience with thesevolatile encounters. The goal for this study was to quantify and describe acts of violence against emergencymedicine (EM) residents by patients and visitors and to identify perceived barriers to safety.

Methods: This cross-sectional survey study queried EM residents at multiple New York City hospitals. Theprimary outcome was the incidence of violence experienced by residents while working in the ED. Thesecondary outcomes were the subtypes of violence experienced by residents, as well as the perceivedbarriers to safety while at work.

Results: A majority of residents (66%, 78/119) reported experiencing at least one act of physical violenceduring an ED shift. Nearly all residents (97%, 115/119) experienced verbal harassment, 78% (93/119) hadexperienced verbal threats, and 52% (62/119) reported sexual harassment. Almost a quarter of residentsfelt safe “Occasionally,” “Seldom” or “Never” while at work. Patient-based factors most commonly cited ascontributory to violence included substance use and psychiatric disease.

Conclusion: Self-reported violence against EM residents appears to be a significant problem. Incidenceof violence and patient risk factors are similar to what has been found previously for other ED staff.Understanding the prevalence of workplace violence as well as the related systems, environmental, andpatient-based factors is essential for future prevention efforts. [West J Emerg Med. 2016;17(5)567-573.]