Sexual harassment in the workplace is like an iceberg, explains a 2018 report from the National Academies of Sciences, Engineering, and Medicine. Behaviors above the surface, such as unwanted sexual attention and sexual coercion, are easily seen. But the vast majority of sexual harassment occurs subsurface, in ways that are often overlooked and underreported: words and actions that convey hostility, objectification or subordinate status toward members of one gender.
A more recent report from the Association of American Medical Colleges showed that, between 2019 and 2021, 34% of women faculty and 22% of all faculty in U.S. medical schools have experienced sexual harassment.
Seen or not, sexual harassment can, like an iceberg, do irreversible damage to careers, research projects and organizations. And it leads to a loss of talent as women -- especially those with intersectional identities -- and sexual and gender minorities leave the workforce. This is especially problematic for the biomedical research workplace, where four conditions known to contribute to sexual harassment -- male-dominated work settings, workplace hierarchy, settings of isolation and a culture of tolerance for sexual harassment -- are prevalent, according to the National Academies' 2018 report.
How can we put a stop to sexual harassment in the biomedical research workplace? To find out, the National Institutes of Health is funding a Stanford Medicine-led study, "Sexual harassment Training Of Principal investigators," or STOP. Through virtual, multimodal trainings that incorporate interactive gaming elements, the goal of the five-year study is to decrease sexual harassment and improve the retention of women in science.
Principal investigator Arghavan Salles, MD, PhD, clinical associate professor of medicine, along with collaborators at Stanford Medicine, Howard University College of Medicine, Yale School of Medicine, the Center for Institutional Courage and University of Chicago, will spend the first year of the grant developing the training modules. The interactive gaming components will be developed in collaboration with Yale's play2PREVENT Lab, with the goal of allowing for role-playing in a low-stakes environment. For instance, Salles and her team are developing scenarios in which individuals can witness inappropriate behaviors in the workplace and decide how to intervene.
"Our hope is that it will be more engaging for people," Salles said. "We know that one hour of diversity training doesn't really change anything. Even though it's hard to get people's time, we felt it was important to have more content and to spread it out over several sessions for repeated exposure."
For Salles and her team, the NIH's T32 grant programs -- which support 1-2-year post-doctoral fellowships in thousands of labs across the country -- presented an ideal environment to test the training: In sheer numbers, they are significant contributors to the biomedical research workforce. And post-doctoral fellows are at an early, decisive stage in their career when intervention on sexual harassment can make a lasting difference. The researchers plan to enroll up to 360 T32-funded programs nationally to participate in the randomized, controlled study -- with specific focus on enrolling programs in minority-serving institutions.
People with multiple marginalized identities are more likely to experience sexual harassment and other behaviors such as microaggressions -- including, for example, subtle insults or invalidating language or behavior -- and discrimination, Salles said. "It's really important that we see if the training we develop will also help those people, who really are the most vulnerable."
"It's crucially important that we create inclusive, welcoming environments, especially for people training in T32 programs," said Douglas K. Owens, MD, professor and chair of the Department of Health Policy in the School of Medicine and a collaborator on the STOP research. "This is the stage of their career where they're making really important decisions about what they'll pursue - whether they'll go into academics, and if so in what role. It's a time when they need an environment that can help them flourish. Learning how to create that is our goal."
The study will measure whether the training can increase principal investigators' and mentors' confidence in their ability to identify and intervene on sexual harassment, microaggressions and unconscious bias; decrease sexual harassment and microaggressions among mentees and increase a sense of civility, belonging, well-being, productivity and persistence in their research career; and help create a more inclusive, positive culture in the research environment.
"It gives me so much optimism that the NIH is willing to fund this work," Salles said. "It really makes me hopeful that, with their commitment, we'll be able to figure out whether this approach works, and to what extent, so we can eventually shift the culture in biomedical research and perhaps even more broadly in medicine."
Photo by MR