Literature and the Evidence Base
Here you will be able to find links to the evidence base supporting just how huge the impact of civility is on the individual, the team and most importantly the patient. More and more research is surfacing, and these links are by no means exhaustive, but hopefully a start.
We have collated links to some incredible websites and organisations, championing and promoting civility in the workplace. Whether you prefer to access this information through podcasts, blogs or videos we hope there is something for everyone.
- Francis Report (Report of the Mid-Staffordshire NHS Foundation Trust public inquiry) and the Government’s response - House of Commons Library (parliament.uk)
- Kennedy Review Report into children’s heart surgery at the Bristol Royal Infirmary (wales.nhs.uk)
- Kirkup Report of the Morecambe Bay Investigation (publishing.service.gov.uk)
- Mazars Report of the Review of MH and LD deaths at Southern Health NHSFT- 16.12.15 (england.nhs.uk)
- Ockenden report from the independent review of maternity services at The Shrewsbury and Telford Hospital NHS Trust (ockendenmaternityreview.org.uk)
- O’Hara Report of the Inquiry into Hyponatraemia related Deaths in Northern Ireland (ihrdni.org)
2014: Building a supportive environment: a review to tackle undermining and bullying in the workplace, view more here.
Findings from a review focusing on these behaviours in training (surgery and obstetrics and gynaecology).
2016: Tackling behaviours that undermine a culture of safety.
An interim report by the Academy of Medical Royal Colleges’ trainee doctors Group (ATDG) they explored bullying and undermining within the medical workforce in the UK. It looked at current efforts to tackle problems and what further work is required.
Visit their website here.
An Australian run organisation for junior doctors and medical students to “empower the next generation of patient-centered doctors”. They provide a series of podcasts, blogs and practical information.
Find out more about RCOG here.
The RCOG has developed a tool kit comprising of 8 modules, including:
- support the development of positive workplace culture
- support you when you encounter poor workplace behaviours
- strengthen your skills and confidence in 'speaking up'
- promote an understanding of what poor workplace behaviour looks like and its impact on individuals, teams, organisations and importantly the women and families we care for.
Are healthcare professionals aiming to raise awareness of the power of civility in medicine, and have a wealth of office-based research available demonstrating the negative outcomes of incivility in the workplace. More details here.
Visit their page for more information here.
View more here.
Find out more about Gathering of Kindness here.
Find out more here.
A podcast, from Learning from Excellence and Civility Saves Lives. This podcast is a series of conversations with people who inspire us, about making healthcare a better place to work. They cover a wealth of topics, from workplace cultures, through inspiration, laughter and joy, to appreciative inquiry and how do work safely.
Available on Apple Podcasts and Spotify.
Vascular surgery podcast but really varied mix including a series on “Race & Representation” and non-technical skills for surgeons.
Available on Apple Podcasts.
Listen on Apple Podcasts.
Available on Apple Podcasts.
- Sexual assault in surgery: a painful truth. Fleming S, Fisher RA. Bulletin of The Royal College of Surgeons of England 103(6):282-285. https://publishing.rcseng.ac.uk/doi/full/10.1308/rcsbull.2021.106
- The price of incivility. Porath C, Pearson C. Harv Bus Rev. 2013 Jan-Feb; 91(1-2);114-21, 146 (Accessed 26/04/2019 at https://hbr.org/2013/01/the-price-of-incivility)
- The Impact of Rudeness on Medical Team Performance: A Randomized Trial. Arieh Riskin, Amir Erez, Trevor A. Foulk, Amir Kugelman, Ayala Gover, Irit Shoris, Kinneret S. Riskin, Peter A. Bamberger. Paediatrics. 2015 September. Volume 136 (issue 3). Accessed online 17/03/2019 https://pediatrics.aappublications.org/content/136/3/487
- Prevalence of bullying, discrimination and sexual harassment in surgery in Australasia. Cebbin W, Cambell G, Hillis D, Watters DA. ANZ J Surg 85 (2015) 905-909.
- Bullying, undermining and harassment in vascular surgical training: How can it be confronted? Fisher R, McBride O, Murray A, Awopetu A. Eur J Vasc Endovasc Surg. 2018 Oct;56(4):603-604.
- Bullying and sexual discrimination in the Greek health care system. Chrysafi P, Simou A, Makris M, Malietzis G, Makris GC. Journal of Surgical Education 2017 (Aug); 74(4):690-697.
- Significant numbers of consultant obstetricians and gynaecologists report bullying. Wise, J. BMJ 2016;353:i3576.
- Do surgeons react?: A retrospective analysis of surgeons’ response to harrassment of a colleague during simulated operating theatre scenarios. Gostlow H, Vega CV, Marlow N, Babidge W, Maddern G. Ann Surg 2018 Aug;268(2):277-281
- Bartholomew A., Sanatkar S., Counson I. and Harvey S. (2022) Junior doctors' mental health and coronavirus disease safety concerns. Australian and New Zealand Journal of Public Health. Vol. 46;2. DOI:10.1111/1753-6405.13213
- Cochran A.L., and Elder W.B. (2015). Effects of disruptive surgeon behavior in the operating room. American journal of surgery. Vol.209;1 pp. 65-70. DOI:10.1016/j.amjsurg.2014.09.017
- Dixon-Woods, M., Baker, R., Charles, K., Dawson, J.F., Jerzembek, G.S., Martin, G.P., McCarthy, I., McKee, L., Minion, J., Ozieranski, P., Willars, J., Wilkie, P., & West, M. (2014). Culture and behaviour in the English National Health Service: overview of lessons from a large multimethod study. BMJ Quality & Safety. Vol. 23, pp. 106 - 115. DOI: 10.1136/bmjqs-2013-001947
- Estebe J., Oger E., Belbachir A., Ecoï¬ey C., and Bonnet F. (2020). Harassment and Bullying In the Operatve Theatre: An Evaluaton Based on an Anonymous Survey Conducted In France. Diversity and equality in health and care. Vol. 17;4, pp. 127-135. DOI:10.36648/2049-5471.17.4.203
- Fay, D., Borrill, C., Amir, Z., Haward, R.A., & West, M. (2006). Getting the most out of multidisciplinary teams: A multi-sample study of team innovation in health care. Journal of Occupational and Organizational Psychology. Vol. 79, pp. 553-567. DOI:10.1348/096317905X72128
- Ferguson, C. (2015). Bullying in surgery. The New Zealand medical journal. Vol. 128;1424, pp. 7-10. PMID: 26922441.
- Fnais N., Soobiah C., Chen M.H., Lillie E., Perrier L., Tashkhandi M., Straus S.E., Mamdani M.M., Al-Omran M., and Tricco A.C. (2014). Harassment and Discrimination in Medical Training: A Systematic Review and Meta-Analysis. Academic Medicine. Vol.89, pp. 817–827. DOI: 10.1097/ACM.0000000000000200
- Henning M.A., Stonyer J.E., Chen Y., Hove B.A., Moir F., and Webster C.S. (2021). Medical Students' Experience of Harassment and Its Impact on Quality of Life: a Scoping Review. Medical science educator. Vol. 31;4, pp. 1487-1499. DOI:10.1007/S40670-021-01301-2
- Ling M., Young C.J., Shepherd H.L., Mak C., and Saw R.P. (2016) Workplace Bullying in Surgery. World Journal of Surgery. Vol. 40;11, pp. 2560-2566. DOI: 10.1007/s00268-016-3642-7
- McNally S.A. (2016). Sexual harassment and bullying in UK surgery: no room for complacency. British Medical Journal. Vol. 354. DOI:10.1136/bmj.i4682
- Montgomery C., Parkin S. Chisholm A., and Locock L. (2020) 'Team capital’ in quality improvement teams: findings from an ethnographic study of front-line quality improvement in the NHS. BMJ Open Quality. Vol. 9. DOI: 10.1136/bmjoq-2020-000948
- Paice E., and Smith D. (2009). Bullying of trainee doctors is a patient safety issue. The Clinical Teacher. Vol. 6. DOI:10.1111/j.1743-498X.2008.00251.x
- Pfifferling J.H. (1999). The disruptive physician. A quality of professional life factor. Physician executive. Vol. 25;2 pp. 56-61. PMID: 10351731
- Porath C.L., and Erez A. (2009). Overlooked but not untouched: How rudeness reduces onlookers’ performance on routine and creative tasks. Organizational Behavior and Human Decision Processes. Vol.109, pp. 29-44. DOI:10.1016/J.OBHDP.2009.01.003
- Quine L. (2002) Workplace bullying in junior doctors: questionnaire survey. BMJ (Clinical Research Ed.). Vol. 324;7342, pp.878-879. DOI: 10.1136/bmj.324.7342.878
- Randle J. (2011) Workplace bullying in the NHS. Journal of Perioperative Practice. Vol. 21;11, pp. 391-394. DOI: 10.1177/175045891102101105
- Riley R., Buszewicz M., Kokab F., Teoh K., Gopfert A., Taylor A., van Hove M., Martin J. T., Appleby L. and Chew-Graham C. (2021) Sources of work-related psychological distress experienced by UK-wide foundation and junior doctors: a qualitative study. BMJ Open. Vol. 11. DOI: 10.1136/bmjopen-2020-043521
- Riley, R., Kokab, F., Buszewicz, M., Gopfert, A., van Hove, M., Taylor, A.K., Teoh, K.R., Martin, J.T., Appleby, L., & Chew‐Graham, C.A. (2021). Protective factors and sources of support in the workplace as experienced by UK foundation and junior doctors: a qualitative study. BMJ Open. Vol. 11. DOI:10.1136/bmjopen-2020-045588
- Riskin A., Erez A., Foulk T.A., Kugelman A., Gover A., Shoris I., Riskin K.S., and Bamberger P.A. (2015). The Impact of Rudeness on Medical Team Performance: A Randomized Trial. Pediatrics. Vol136, pp. 487 – 495 DOI:10.1542/peds.2015-1385
- Riskin A., Erez A., Foulk T.A., Riskin-Geuz K.S., Ziv A., Sela R., Pessach-Gelblum L., and Bamberger P.A. (2017) Rudeness and Medical Team Performance. Pediatrics. Vol. 139;2 DOI: 10.1542/peds.2016-2305
- Rogers, A.C., Wren, S.M., and McNamara, D.A. (2019). Gender and Specialty Influences on Personal and Professional Life Among Trainees. Annals of Surgery. Vol. 269, pp. 383–387. DOI:10.1097/SLA.0000000000002580
- Rosenstein A. and O'Daniel M. (2008). A Survey of the Impact of Disruptive Behaviors and Communication Defects on Patient Safety. Joint Commission Journal on Quality and Patient Safety / Joint Commission Resources. Vol. 34 pp464 – 471. DOI:10.1016/S1553-7250(08)34058-6
- Samsudin E.Z., Isahak M., and Rampal S. (2018). The prevalence, risk factors and outcomes of workplace bullying among junior doctors: a systematic review. European Journal of Work and Organizational Psychology. Vol. 27 pp. 700 - 718. DOI:10.1080/1359432X.2018.1502171
- Schizas D., Papapanou M., Routsi E., Mastoraki A., Lidoriki I., Zavras N., Avgerinos D.V., Lazaris A., and Tsaroucha A.K. (2022). Career barriers for women in surgery. The Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland. (Pre-print) DOI:10.1016/j.surge.2021.11.008
- Scott J., Blanshard C., and Child S. (2008). Workplace bullying of junior doctors: cross-sectional questionnaire survey. The New Zealand medical journal. Vol. 121;1282. PMID: 18815599
- Shabazz T., Parry-Smith W., Oates S.E., Henderson S.J., and Mountfield J. (2016). Consultants as victims of bullying and undermining: a survey of Royal College of Obstetricians and Gynaecologists consultant experiences. BMJ Open. Vol. 6. DOI:10.1136/bmjopen-2016-011462
- Stamp N., and Patterson I. (2016). Bullying in surgery isn’t just Australia’s problem. British Medical Journal. Vol. 354. DOI:10.1136/bmj.i5188
- Timm A. (2014) 'It would not be tolerated in any other profession except medicine': survey reporting on undergraduates' exposure to bullying and harassment in their first placement year. BMJ open. Vol. 4;e005140. DOI: 10.1136/bmjopen-2014-005140
- West M. A., Markiewicz L. (2016) ‘Effective Team Working in Healthcare.’ In Ferlie E., Montgomery K. and Pedersen A. R. (Eds), The Oxford Handbook of Health Care Management. Oxford UK, Oxford University Press. pp. 231-252. DOI: 10.1093/oxfordhb/9780198705109.013.8
- West MA, Markiewicz, L. Effective Team Working in Healthcare. The Oxford Handbook of Health Care Management: Oxford University Press; 2016. p. 231-52.
- Burford B MG, Illing J, Carter M, Thompson N, Crampton P. Evidence synthesis on the occurrence, causes, consequences, prevention and management of bullying and harassing behaviours to inform decision-making in the NHS. In: Research NIfH, editor. http://www.netscc.ac.uk/hsdr/files/project/SDO_FR_10-1012-01_V07.pdf2013
- ACAS. Help and Advice for employers and employees: bullying and harrassment http://www.acas.org.uk/index.aspx?articleid=1864
- Quine L. Workplace bullying in junior doctors: questionnaire survey. BMJ (Clinical research ed). 2002;324(7342):878-9.
- Randle J. Workplace bullying in the NHS. Journal of perioperative practice. 2011;21(11):391-4.
- Timm A. 'It would not be tolerated in any other profession except medicine': survey reporting on undergraduates' exposure to bullying and harassment in their first placement year. BMJ open. 2014;4(7):e005140.
- Council GM. National Training Survey 2014: bullying and undermining. http://www.gmc-uk.org/NTS_bullying_and_undermining_report_2014_FINAL.pdf_58648010.pdf2014
- Ferguson C. Bullying in surgery. The New Zealand medical journal. 2015;128(1424):7-10.
- Ling M, Young CJ, Shepherd HL, Mak C, Saw RP. Workplace Bullying in Surgery. World journal of surgery. 2016;40(11):2560-6.
- McNally S. Sexual harassment and bullying in UK surgery: no room for complacency. BMJ (Clinical research ed). 2016;354:i4682.
- Stamp N, Patterson I. Bullying in surgery isn't just Australia's problem. BMJ (Clinical research ed). 2016;354:i5188.
- Shabazz T, Parry-Smith W, Oates S, Henderson S, Mountfield J. Consultants as victims of bullying and undermining: a survey of Royal College of Obstetricians and Gynaecologists consultant experiences. BMJ open. 2016;6(6):e011462.
- Smith R. Trainee surgeons more likely to be bullied: survey. The Telegraph. 2014.
- B K. Result of the Morecombe Bay Investigation. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/408480/47487_MBI_Accessible_v0.1.pdf2015
- Francis R. Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry - Executive Summary. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/279124/0947.pdf2013
- Cochran A, Elder WB. Effects of disruptive surgeon behavior in the operating room. American journal of surgery. 2015;209(1):65-70.
- Porath CL, Erez A. Overlooked but not untouched: How rudeness reduces onlookers’ performance on routine and creative tasks. Organizational Behavior and Human Decision Processes. 2009;109(1):29-44.
- Riskin A, Erez A, Foulk TA, Kugelman A, Gover A, Shoris I, et al. The Impact of Rudeness on Medical Team Performance: A Randomized Trial. Pediatrics. 2015;136(3):487-95.
- Riskin A, Erez A, Foulk TA, Riskin-Geuz KS, Ziv A, Sela R, et al. Rudeness and Medical Team Performance. Pediatrics. 2017;139(2).
- Rosenstein AH, O'Daniel M. A survey of the impact of disruptive behaviors and communication defects on patient safety. Joint Commission journal on quality and patient safety. 2008;34(8):464-71.
- Abdul B, Duncan S, Alice H, Megan G, Sri R, Rana S, Simon K, Narain M. Bullying, Harassment, and Undermining Behavior in Cardiothoracic Surgery in the United Kingdom and Ireland. The Annals of Thoracic Surgery.2024;0(0):1-8.