Identifying and acting on bullying

One of my favourite presentations at the Australasian Doctors’ Health Conference was by Dr Fiona Moir. Her research was on HOTSPOTS: outcomes & lessons after 3 years of an initiative to identify and act on bullying, harassment and discrimination in the Auckland Medical Programme.

HOTSPOTS is an anonymous online system for reporting experiences of bullying, harassment, discrimination (BDH), inclusion and respect (IR) on clinical placements.

We know that bullying, harassment and discrimination is still, unfortunately, a part of life in medicine. In the recent Medical Training Survey, 35% experienced or witnessed bullying, harassment and/or discrimination, including racism. HOTSPOTS aims to identify where these damaging behaviours are happening and in identifying it, then being able to act on it.

They also added inclusion and respect, as the mere absence of bullying, harassment and discrimination does not = respect & inclusion or a nurturing work environment.

How was study conducted

The data was collected from medical students in year 4-6 twice a year. If there were less than 15 students from that rotation they would not release the information to create ‘safety in numbers’. It was anonymous to protect the students and allow them to feel they can be honest about their experiences.

There was no open text in the reporting system, so it was more about where not who. Which department, which specialty rather than naming names.

Findings & Benefits

The results of the surveys were presented as a heat scale visually, to show that ‘hotspots’ were where attention should be directed to address larger numbers of BDH.

The Programme then met with the individual chief medical officer and academic leader to discuss the results.

After doing this for three years, they noticed an improvement in ‘hotspots’ as well as notice emerging areas needing attention before they get completely ‘hot’.

What next?

They are now looking at sharing this with other organisations and increase funding to continue this programme and evaluate it.

Let’s hope this initiative spreads for all medical students and doctors in training.

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