The prevalence,risk factors and outcomes of workplace bullying among junior doctors: a systematic review

ABSTRACT

Junior doctors’ exposure to bullying may impact their training and compromise quality healthcare, yet little is known in relation to its predictors and effects. The aim of this paper is to assess the prevalence, factors and outcomes of workplace bullying among junior doctors. Literature search was performed to identify all primary studies examining workplace bullying among junior doctors using the following electronic databases: Medline, Scopus, Web of Science, PsycINFO and Cochrane Library. A total of 18 articles were included, reporting on a total of 9,597 junior doctors. The quality of evidence can be rated as moderate according to the Newcastle Ottawa Scale. From the review, a wide range (30–95%) of bullying prevalence, significant differences in bullying rates according to gender, age, height, ethnicity and subspecialty, and significant associations between bullying and mental strain, job dissatisfaction, burnout, and increased accidents at work were observed. Concurrently, heterogeneity in the terms and methodologies used to examine workplace bullying as well as definitional issues in relation to the persistency of negative interactions were noted. Evidence suggests that workplace bullying is a serious occupational hazard for junior doctors, and more research is warranted to better understand this phenomenon and address its definitional and methodological issues.     

The world turns at 33 and 45: Defining simple cutoff scores for the Negative Acts Questionnaire–Revised in a representative sample

Workplace bullying is a serious hazard in every day working life that needs to be assessed carefully. In order to achieve such a goal, both victims of severe bullying as well as targets of less intensive bullying need to be identified, the latter in order to prevent further escalation into severe bullying. Previous research has mainly offered simple and crude measures of who is and who is not a victim of bullying. In this article we show how cutoff scores for the scale Negative Acts Questionnaire–Revised (NAQ-R) can be calculated. Based on a representative sample of the Norwegian workforce, we formulated 2 cutoff points or thresholds for the NAQ-R with a Receiver Operation Characteristic curve. Employees with a score lower than 33 are not bullied, employees with a score between 33 and 45 may be considered as being bullied occasionally, and employees who score above 45 can be considered to be victims of workplace bullying. As the NAQ-R is used in more than 300 research projects worldwide, we hope to inspire other scholars to define similar cutoff points. In addition, we hope that clear cutoff scores may be of assistance to practitioners for designing interventions regarding workplace bullying in line with the identified problems.     

Problems of assessment in religious and moral education: the Scottish case

This article is concerned with assessment issues in Religious and Moral Education (RME) offered in Scottish non-denominational schools. The analysis of the findings in this article is weighed against the framework of the new ‘3–18’ Scottish curriculum called ‘Curriculum for Excellence’ (CfE). CfE was introduced in primary schools in 2009 and a year later in secondary schools as replacement of the much criticised ‘5–14’ Curriculum which had been in use since 1992. It is based on qualitative data collected from schools in five Scottish local authorities between 2009 and 2011 as part of a moderation project. What is being problematised in this article is the revelation from the data about issues that impact adversely on good assessment in RME in five key areas, namely: planning, religious knowledge, progression, self and peer assessment, literacy and values. The implications of these assessment problems for effective teaching and learning in RME are analysed.     

Universities are not a good place for psychotherapy and counselling training

This paper outlines eight aspects of institutional practice in university teaching that are at odds with the ethos of therapy: the linearity of university training has consequences for conceptual and cultural issues that may be antithetical to genuine therapeutic practice; certain notions about what reality is and what counts as truth may be reinforced by university trainings; academic knowledge in universities is standardized so as to sabotage therapeutic work; the university privileges a cognitive account; the university trains therapists in ways that are antithetical to the ethos of therapy; universities keep alive hierarchies that sit uneasily with the project of therapy; university training encourages the therapist to develop an identity that is anathema to many traditions in therapy; and compartmentalization of ethics in university-based trainings would run against the ethics of therapy.     

A trans-disciplinary study of the therapist's self

Participation in personal therapy during training is required by British accreditation bodies for counselling psychology as well as by most psychotherapy trainings. By contrast, trainee clinical psychologists are not required to undertake personal therapy, although they may elect to. Prior research in Britain and the US suggests that practitioners have a wide range of motives for entering therapy as well as motives for not doing so (Norcross &; Connor, 2005). This study addresses the fact that no research to date has specifically explored what individuals beginning their counselling psychology, clinical psychology and counselling training think and feel about participation in personal therapy during training. Data from open-ended questionnaires was analysed using inductive thematic analysis. Two main themes were identified. These consisted of: ‘Personal therapy helps me to be a better practitioner’, and ‘Personal therapy costs me’. The study results are considered in light of the limited prior research and recommendations for training are made.     

The validation of a religiosity measure for individuals with schizophrenia

Measures of religiosity validated for psychotic patients do not exist. This study sought to examine the psychometric properties of a modified version of the Religious Life Inventory (RLI) in this population. It was anticipated that religiosity would be affected by psychotic symptoms. The religiosity of patients with schizophrenia was assessed while symptoms were more evident and again after treatment, to evaluate changes in religiosity. Four factors were found which characterized the religiosity of people with schizophrenia. These factors were found to have good construct validity. Patient's responses indicated a reduced need for religion when re-assessed once symptom scores were reduced.     

Advanced Brief Strategic Therapy: An overview of interventions with eating disorders to exemplify how theory and practice work

This paper aims at introducing some of the central aspects of the evolution that brief strategic therapy has undergone at the Centro di Terapia Strategica of Arezzo, Italy, towards advanced therapeutic strategies which differ from the original Palo Alto model. (Fisch, Weakland, &; Segal, 1982; Watzlawick, 1978 Watzlawick, P. 1978. The language of change: Elements of therapeutic communication, New York: Basic Books.  [Google Scholar]; Watzlawick, Beavin, &; Jackson, 1967; Watzlawick, Weakland, &; Fisch, 1974). We will focus on how the concept of self-deception is central to the formation and the persistence of psychological disorders; and how the usage of non-ordinary logics and the understanding of the individual's perceptive-reactive system are of key importance in unravelling such disorders, allowing the therapist to guide the patient towards an efficacious and efficient solution. Rather than attempting to describe and enlist the theoretical corpus that underlies brief strategic therapy, we have chosen to exemplify some focal concepts that connect theory to practice, and vice versa, by presenting the outline of some therapeutic protocols devised for solving eating disorders which can be specifically tailored for each individual patient.     

Examining the role and functions of self-development in healthcare therapy trainings: A review of the literature with a modest proposal for the use of learning agreements

Many healthcare trainings with a psychodynamic orientation encourage or require students to commit to a process of personal development, such as provided through attending individual psychotherapy and/or an experiential ‘as if therapy’ group. This paper reviews recent literature about training in psychodynamically oriented practices within counselling psychotherapy, psychiatry, the creative arts therapies and clinical psychology. The results indicate that the mandatory personal development dimension of therapy training needs urgent reassessment. Results of studies consistently call for further research about the direct benefits of personal development on students’ development of skills for therapy practice. There is minimal evidence to indicate what self-development through individual psychotherapy can specifically deliver in terms of eventual professional competence. To address some aspects of the current lacuna, this paper summarises the recommendations for training programmes available from the current research, and makes a modest proposal for the use of learning agreements, rather than only mandated hurdle requirements, to ensure that the incremental steps by which the student attains expected requirements is negotiated and agreed within regularised, and widely accepted university course procedures.