Empowering students to speak up
Griffith University’s medical school is focused on empowering students to create change, from the bottom up, in the clinical training environment.
In 2019, final-year medical student Dr Danielle Walker and I ran a survey of our medical students which pointed to an ongoing epidemic of bullying and harassment in the medical workplace culture. The students who responded generally believed that reporting incidents would have negative ramifications for them, both personally and professionally. They believed that the repercussions could come from future employers, colleagues, their clinic site or the School of Medicine, and affect their physical and mental health.
Danielle, a mature-age student, had herself experienced bullying during clinical placements. Being older, she could stand up to the bullies and had the courage to tell them their behaviour was inappropriate. But she saw the fear of the other students, and that many of them would rather struggle through than speak out or report their experiences of BHD&SH. It was clear a bottom-up change was needed, through the empowering of students.
Griffith has a zero tolerance approach to bullying and we have appointed three trained Harassment and Discrimination Contact Officers (HDCOs), including myself, for our medical campuses on the Gold Coast and the Sunshine Coast.
HDCOs are available to people (staff or students) who feel they have been the subject of BHD&SH. Our role is to be a confidential point of contact, to listen to concerns, explain university policies and procedures, and provide information on the resolution options that are available to staff and students.
To get the message out to students, we deliver lectures on BHD&SH each year – to first- and second-year medical students – with regularly updated information. We place flyers around the clinical zones to remind students of the availability of the contact officer, and we continue to survey students about how best we might be able to assist them.
To give an example of how we work, when a complaint was made by a couple of students in one of the clinical zones about the bullying and discrimination they experienced, it was first discussed with the contact officer and then brought to the attention of both the school and the clinical sub-dean. The initial management response was the delivery of a grand rounds presentation on the impact of BHD&SH on medical students and staff, with the alleged perpetrator present to hear this information. After that, the individual was removed from teaching medical students at that zone.
“The individual was removed from teaching medical students at that zone.”
Often students seek help for all levels of distress and, after discussing what has taken place, about 50 per cent of the time we find that bullying has occurred. In many of these situations, the students want to know how to manage the matter themselves. I often find that leaving a record with me of what has happened is enough for the student. In effect they are being heard and are documenting the events in case they happen again.
Unfortunately, while students can bring their issues to us and we have full awareness of them, unless they give us permission to go ahead and do something about it, nothing further takes place. There is undoubtedly still a fear factor that reporting an event could adversely affect them in future. The catch cry I hear all the time is: “these are the people who are going to employ me”.
Connecting into the hospital system
We have had a number of meetings with the clinical teaching staff within the hospital and they are aware of the problem and want to stop it as much as we do, however we do not have any direct power over the medical professionals employed by Queensland Health and NSW Health.
“We have had a number of meetings with the clinical teaching staff within the hospital and they are aware of the problem and want to stop it as much as we do.”
It is a very frustrating situation and one of the things we were going to look at doing was to take the survey results around to the hospitals to inform them that we are aware of what is happening with our students. Like a lot of things, this has been held up by the pandemic.
Another possible strategy is perhaps creating a ‘champion’ within the hospital system.
The long-term solution is to find a way that students feel they can report and be protected – not just as students but also as future doctors. Much more needs to be done to address this situation, however I think it is not going to come about as a top-down change, but more of a bottom-up change. Assisting students to know that their concerns will be listened to and addressed gives a growing confidence to the student.
This story is part of a series: Turning the tide of bullying and harassment in medical education and training