1. Improving Workplace behaviour What can we do? Jo Mountfield Workplace behaviours advisor RCOG © Royal College of Obstetricians and Gynaecologists

2. Aims Inform – Definitions – Data – What the RCOG/GMC are doing about it Practical help-your choice – Discuss a case study in small groups – Videos and discussion

3. What is bullying? Bullying may be characterised as offensive, intimidating, malicious or insulting behaviour, an abuse or misuse of power through means intended to undermine, humiliate, denigrate or injure the recipient.

4. What is harassment? Harassment, in general terms is unwanted conduct affecting the dignity of men and women in the workplace. It may be related to age, sex, race, disability, religion, sexual orientation, nationality or any personal characteristic of the individual, and may be persistent or an isolated incident. The key is that the actions or comments are viewed as demeaning and unacceptable to the recipient.”

5. Bullying and harassment Bullying or harassment may be by an individual against an individual or involve groups of people. It may be obvious or it may be insidious. Whatever form it takes, it is unwarranted and unwelcome to the individual. Harassment is underpinned by the law

6. What is undermining? GMC Survey question: Have you been subjected to persistent behaviour in this post that has undermined your professional confidence and/or self esteem?” to injure or destroy by insidious activity or imperceptible stages, sometimes tending toward a sudden dramatic effect. to attack by indirect, secret, or underhand means; attempt to subvert by stealth.

7. GMC survey 2014 8% Trainees report being the victim of bullying 13.6% had witnessed someone else being bullied in their post – Female and overseas more likely to make a comment about bullying or undermining – Doctors in training who raised a free text comment about bullying or undermining are less satisfied with their training. – Doctors in years four to seven of specialty training are more likely to report undermining than those in foundation or core training

8. GMC 2014 data What was the source of the behaviour? Comments could be coded to more than one behaviour category, so total percentages do not equal 100%. Consultant/GP (inside my post) 53.5% Nurse/midwife 22.0% Consultant/GP (outside my post) 17.6% Other doctor 15.3% Management 12.5% Other source 11.4% Other doctor in training 3.9% Patient/relative1.0%

9. Why O&G High percentage of female and overseas trainees Cultural differences Generational and gender differences More acceptable to report than other specialties Midwives (Bypassing)

10. Why O&G High stakes specialty Related to feedback especially at handover No doubt connected to performance issues Reflection of service provision and gaps in rotas Leadership

11. Why O&G Trainer disengagement when “bullying” raised Bullying fatigue Not only the trainees can be bullied/undermined Many have had no training in feedback Resilience Abused become abusers

12. Positivity builds resilience >Barbara Fredrickson www.positiveemotions.orgwww.positiveemotions.org >Positivity ratio > 3:1; Maximum 11>1 Fredrickson & Losada, American Psychologist (2005) 60, 678-686 >(... and negativity is necessary)

13. RCOG action A UK wide RCOG Workplace Advisory Network (WB-NET) is established Local Workplace Behaviours Champions (LWBC). Every LETB/School Positive feedback from trainees committee Engagement with GMC visits –report due March 2015 Roll out of educational interventions

14. RCOG action Toolkit-November 2014 E-Learning package 2015 TEF-more accurate data Support trainees to develop resilience

15. Practical Strategies Discuss your case in small groups?

16. As leaders, you can shape the culture in your departments

17. Videos

18. Do not walk by when you see it happening - have courage and do something about it Be a role model and encourage others to intervene You can make a difference And finally?