PlayDecide teamwork: a discussion game for junior doctors to explore workplace bullying and harassment.

BACKGROUND

Workplace bullying and harassment (WBH) in healthcare settings has been widely described in the literature, although a lack of consensus on the definition of behaviours constituting WBH makes findings difficult to interpret. The consequences for those experiencing WBH can be severe, including burnout, stress, and suicidal ideation, yet formal reporting rates are low, in part due to a lack of understanding of WBH and the support services designed to address it. Those who experience WBH are more likely to reproduce the behaviour, creating a self-perpetuating cycle. There is an urgent need to develop educational tools to help trainees identify behaviours that can constitute WBH, and the support services available to address this issue.

METHODS

The study setting was four acute hospital sites in Ireland; participants were interns (junior doctors in their first postgraduate year). A card-based discussion game, PlayDecide: Teamwork was developed with a multidisciplinary team (MDT), piloted, and implemented. Feedback was obtained from participants on the acceptability and educational value of the game via an anonymous online survey. The intervention is presented using the TIDieR framework. Data were analysed and presented using descriptive statistics.

RESULTS

Intern trainers and facilitators expressed satisfaction with the game. Intern attendance at the PlayDecide sessions was estimated at 63.64% (n = 70), with a 57.14% response rate to the survey (n = 40). The majority of interns found the game acceptable, the cards realistic and relevant, and agreed that it was a safe space to discuss workplace issues. Most interns agreed that the learning objectives had been met, although fewer agreed that they had learned about support services.

CONCLUSION

PlayDecide: Teamwork is to the best of our knowledge the first intervention of its kind aimed at addressing WBH, and the first aimed at interns. We have shown it to be effective and acceptable to interns and intern trainers in the acute hospital setting. We hypothesised that strong group identification facilitated the discussion, and further, that the cards created cognitive distance, allowing for free discussion of the issues depicted without needing to divulge personal experiences. Further evaluation at behavioural and organisational levels is needed.