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Objective: To evaluate how surgeons in Australia and Aotearoa New Zealand perceive the effectiveness of the Operating with Respect (OWR) face-to-face training program in reducing workplace bullying. Methods: A cross-sectional survey examined the perceived effectiveness of the Royal College of Surgeons' (RACS) face-to-face OWR training and complementary interventions in reducing workplace bullying in surgical settings. The sample included supervisory surgeons, RACS committee members, and targeted educators. The survey instrument had 35 questions, including five related to the research question. In December 2020, the survey was distributed by RACS to all surgeons who undertook OWR training between April 2017 and December 2019. Likert scales and coded free text responses were used to explore the effectiveness of face-to-face OWR training and other interventions included in the 2015 RACS Action Plan. Results: Of the 756 surveys sent, 252 were received. The face-to-face OWR training program was rated as moderately effective. RACS's overarching approach to anti-bullying was almost equally important, highlighting the need to consider a broader ecosystem of reform. Conclusions: This study finds the RACS full-day anti-bullying training moderately effective in reducing bullying in surgical workplaces. However, enhancing its impact requires a sustained, multi-faceted strategy, including broader policy reforms, accountability measures, and cultural changes, to foster a long-term respectful environment in surgical settings. What is known about this topic? Anti-bullying interventions, including training, are prevalent in healthcare; however, there is conflicting data on their effectiveness. What does this paper add? This study addresses a gap in the literature on the effectiveness of anti-bullying training from the perspective of supervisory surgeons in Australia and Aotearoa New Zealand. What are the implications for practitioners? Practitioners should consider implementing a multifaceted and sustained approach to anti-bullying reform, including anti-bullying training, well-drafted policies, increased accountability, and improved complaints mechanisms to reduce bullying and improve workplace culture. [ABSTRACT FROM AUTHOR]

Background: A significant body of literature has examined the impact of verbal and non‐verbal bullying in surgical settings, where a central focus has been on the experiences of trainee and junior members of the surgical team, women in surgery and other health professionals, such as nurses. Research on how surgeons' perceive or experience bullying is more limited. Therefore, this study aims to investigate the views of surgeons on negative and disrespectful verbal and non‐verbal behaviour and bullying in surgical settings, including its impact on surgeons themselves and the surgical staff they oversee. Methods: Semi‐structured interviews were undertaken with surgeons between February and November 2019. Questions explored surgeons' perceptions of interpersonal communication and behaviour in their surgical workplaces in the preceding 6‐months. A narrative analysis approach was used to code, interpret, and report the interview data. Results: Thirty‐one interviews were conducted with surgeons (19 male and 12 female), from Australia (26) and Aotearoa New Zealand (5) from 10 surgical specialties. Three themes were identified with associated subthemes: bullying (five subthemes), non‐verbal bullying (seven subthemes), and impact and outcomes of bullying (six subthemes). Conclusion: This study revealed a notable shift in the reported verbal and non‐verbal bullying behaviour among surgeons, demonstrating a decrease in intensity, physicality and violence for the 6‐months prior to interviews conducted in 2019, when compared with surgeons' historic experiences. Despite reported behaviour being more subtle and indirect, it nonetheless continues to have a marked impact on many surgeons as well as the staff they oversee. This study investigated the perspectives of surgeons on disrespectful behaviour and bullying in surgical settings. Thirty‐one interviews with surgeons from Australia and Aotearoa New Zealand were conducted, revealing three themes: verbal bullying, non‐verbal bullying, and the impact and outcomes of bullying. Despite becoming more subtle and indirect, bullying continues to significantly impact surgeons and the staff they oversee. [ABSTRACT FROM AUTHOR]

Objective. The objective of this research is to appraise current practice in hospitals against the ‘Framework to achieve value in healthcare’ (the Framework) and to identify additional contributory factors that support or hinder its application. Methods. A multi-site case study was undertaken with five hospitals in Australia, the USA and UK using purposeful sampling to identify hospitals to participate. Data collection took place between September and November 2022. The hospitals included in the study had Process Improvement (PI) programs of more than 5 years duration, with strong executive engagement and broad outcomes measurement, including financial benefits. All hospitals were acute public hospitals or private, not for profit. Results. All hospitals indicated current practice according to Steps 1–5 for some part of their PI programs. All hospitals indicated that they were more likely to include financial benefits measurement for activities aimed specifically at improving cost rather than reducing non-value adding activities or improving the value of clinical care. Step 5 (reinvestment of cost savings) of the Framework is dependent on the accomplishment of Step 4 (measurement and realisation of financial benefits) and the contributory elements are important in supporting hospitals to utilise the Framework. Conclusions. The ‘Framework to achieve value in healthcare’ provides a practical guide for hospitals to reduce non-value adding activities, improve the value of clinical care and reduce costs. Further research is indicated to establish its reliability in hospitals in other countries and hospitals that do not have an established PI program. [ABSTRACT FROM AUTHOR]

The shift to Vocational Education and Training (VET) for the training of the Australian residential aged care workforce has resulted in significant variance in the competencies at graduation of those caring for people with dementia. Competence may be also be enhanced, or conversely, decline over time as a result of implicit learning gained from workplace experience. Evaluating the skills and knowledge of the workforce is a challenge for supervisors. A single valid assessment tool that can evaluate staff knowledge across the competence continuum, from personal care workers to registered nurses, is required. An existing case study-based summative test of knowledge was chosen to be used in conjunction with a newly-developed marking rubric. The rubric was designed to differentiate between answers from different levels of staff. The assessment task and rubric were tested on a representative sample of the competent Australian residential aged care workforce with the appropriate skills mix. Evidence of the adequacy with which the test represents the national dementia-care competency, the responses of test users to the problem-solving content of the case study and the validity of the scores have been established. The validated scores were found to establish normal distributions, or ranks of knowledge for the different levels of staff. Potentially these permit the evaluation of the performance of groups of staff in residential aged care facilities against the distributions of scores. (Contains 1 figure and 4 tables.)