IMPORTANCE Workplace violence (WPV) is a worldwide problem in health services. Several studies have pointed to organizational factors, such as working in psychiatry and work stress. However, there is a lack of long-term longitudinal cohort studies with respect to trends during the career and individual factors among physicians. OBJECTIVE To investigate WPV trends during Norwegian physicians' careers and assess individual and work-related factors associated with WPV in a long-term longitudinal study. DESIGN, SETTING, AND PARTICIPANTS This cohort study involved 2 nationwide medical student cohorts who graduated 6 years apart and were surveyed at graduation (T1: 1993-1994 and 1999) and 4 years later (T2), 10 years later (T3), 15 years later (T4), and 20 years after graduation (T5).

IntroductionWorkplace violence (WPV) is a worldwide health problem with major individual and societal consequences. Previously identified predictors of WPV include working in psychiatry and work stress.ObjectivesTo investigate WPV trends during Norwegian doctors’ careers and assess individual long-term predictors in a longitudinal study.MethodsTwo nationwide medical student cohorts (n=1052) who graduated 6 years apart were surveyed at graduation (T1, 1993/94 and 1999) and 4 (T2), 10 (T3), 15 (T4) and 20 (T5) years after graduation (Figure 1). WPV was measured as multiple threats or acts of violence experienced at least twice. Individual predictors were obtained at T1 and work-related factors at T2–T5. WPV was analysed using repeated measures (Generalized Estimating Equations).ResultsThe prevalence of multiple threats and acts of violence declined at T2–T5 (p<0.001). Adjusted predictors of threats were male gender (odds ratio, OR 2.76, [95% confidence interval] 1.73–4.40; p<0.001), vulnerability traits (OR 0.90, [0.82–0.99]; p=0.031), older cohort (OR 1.63,[1.04–2.58], p=0.035) and working in psychiatry (OR 7.50, [4.42–12.71]; p<0.001). Adjusted predictors of acts were male gender (OR 3.37, [1.45–7.84]; p=0.005), older cohort (OR 6.08, [1.68–21.97]; p=0.006) and working in psychiatry (OR 12.34, [5.40–28.23]; p<0.001).ConclusionsHigher rates of multiple threats and acts of violence were observed during early medical careers, with men at higher risk. Low levels of vulnerability traits (neuroticism) predicted independently the experience of violent threats. A cohort effect indicated a reduction in WPV (both threats and acts) in the younger cohort.