Team tackling bullying wins national award

A University of Auckland team that has successfully tackled various forms of bullying on medical students’ clinical placements has won a national health and safety award.

The Faculty of Medical and Health Sciences team collaboratively developed a system for senior medical students to anonymously report bullying, harassment and discrimination on clinical placements – as well as excellence, inclusion and respect.

Dr Fiona Moir, Associate Professor Andy Wearn and Dr Bradley Patten led the project, dubbed “Hotspots”, which won the Collaboration category of the Safeguard New Zealand Workplace Health and Safety Award at a gala awards ceremony on 21 June.

“I was working as Director of Medical Student Affairs, a student support role, and had seen a few students who had raised concerns about unprofessional behaviour, but not been confident about how to report that,” Moir says. “I felt we should do something.”

Starting around five years ago, Moir talked to fellow directors about how to create an anonymous reporting system that was safe and respectful to staff and students, and one that could acknowledge excellence, as well as issues of concern.

Students have clinical placements in eight North Island District Health Boards, in hospitals and general practices.

“The purpose of the initiative was to identify outliers, so that leaders could take action as required, and students could know that issue were being tackled,” Moir says.

What followed was two-and-a-half years of consultation with academic leaders, student leaders, the national forum for chief medical officers, and a Ministry of Health taskforce on professional behaviour which included representatives from other health professions, unions and the University of Otago

In that time, Moir, Wearn and Patten led development of a platform for twice yearly anonymous surveys, where students’ personal details are removed, data aggregated and access to data strictly limited.

“A significant aspect of the development was the reporting,” Wearn says. “We had to decide how to present the data in a way that was accessible and meaningful.”

Patten, a psychometrician, presents data visually using a heat scale. The survey results are used to produce coloured bar graphs by site or specialty, depending on who the report is sent to. Comparator bars allow high level benchmarking without providing specific data about another site or service.

About three to four weeks after sending the latest report, Moir, Wearn or the Head of Programme meets with the individual chief medical officer and academic leader to discuss the results, ask the leader their thoughts regarding possible causes and actions if required. A generic summary of all actions taken is made available to students and the governance board, without sites being identified.

The surveys started in late 2019 and now, after three years, the leadership team is pleased to see improvements in areas originally identified as “hotspots”, as well as the ability to highlight emerging problem areas and nip them in the bud.

“With Hotspots, one of its central design tenets was that we were going to pinpoint ‘where not who’,” Moir says. “We wanted to highlight areas rather than individuals, so the relevant leader could explore all issues that could have contributed to that behaviour.”

Moir based this on literature suggesting unprofessional behaviour involves a complex interaction of factors, including conduct, competence, health and systems.

"Hotspots was one of our actions to promote positive change, acknowledging that there were some unprofessional and inappropriate interactions between our students and those supervising them in the workplace setting."

Wearn and Moir say getting buy-in at the development stage from students and DHB leaders has been crucial to the success of Hotspots.

Now they are working out how to share the platform with the many other professions and organisations who have expressed an interest in using it, plus working on future research evaluating the initiative.