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A Combined Behavioural Economics- and Simulation-based Medical Education to Promote Effectiveness among Medical Residents in Coping with Workplace Violence in Northern China: A  Quasi-Experimental Study


 Background: Workplace violence is internationally recognized as a major concern for the workforce, which entails serious consequences, and research shows that medical residents are more likely than other doctors to experience violence in the workplace. This study examines the effectiveness of simulation-based medical education on the one hand, and simulation-based medical education combined with behavioural economics on the other as interventions in medical residents' perception of, attitude toward, and self-efficacy in coping with violence in the workplace. Methods: A quasi-experimental design was used, 190 participants having been randomised into three study groups to respectively test the effect of simulation-based medical education only and simulation-based medical education plus with behavioural economics interventions, compared with a control group. Data were obtained from structured questionnaires, including (1) a perception of aggression scale, a management of aggression and violence attitude scale, a general self-efficacy scale, and (2) sociodemographic characteristics. Results: The results show that the scores attained by simulation-based medical education (SBME) and simulation-based medical education combined with behavioural economics (SBME+BE) interventions for perception, attitude, and self-efficacy were significantly higher than those in the control group (p < .01). The SBME+BE group recorded a higher improvement in perception, which could be ascribed to the behavioural economics effect. In addition, the higher perception of workplace violence is correlated with single residents and those with more work experience, prior experiences of violence in the workplace, and training related to workplace violence. A higher positive correlation of workplace violence was recorded by female and widowed residents; and a higher level of self-efficacy related to violence in the workplace correlated with male, widowed and senior (third-year) residents. Conclusions: This study contributes important evidence regarding changes in the perception, attitude, and self-efficacy of subjects following both the SBME+BE and SBME interventions among medical residents in coping with workplace violence, the highest perception change having been recorded after the SBME+BE intervention, which can be explained by the inclusion of behavioural economics.