Examples of disrespectful and respectful behaviours are shown in the two hypothetical videos presented here. In one video the SMO behaves in a respectful manner whereas in the other he behaves disrespectfully.
Both videos, acted by volunteers, depict a teaching session for junior medical officers and students, led by a senior medical officer. The SMO presents a chest X Ray of a patient with a tension pneumothorax and expects the junior medical officer to make a spot diagnosis. The JMO stumbles, and it is unclear whether this represents poor preparation or anxiety.
In 1, the SMO behaves in a disrespectful manner. His impatience is counterproductive and possibly exacerbates the JMO's inability to answer the question. He humiliates the JMO by declaring his failure to make the spot diagnosis and unnecessarily excludes the JMO by handing the task to another JMO without first assisting him. He is impolite and demeaning in his choice of words and body language, both of which are a threat to the JMO personally and professionally. We know from research that the impact of this behaviour will also be felt by the other JMOs who witness it (Samnani, 2013). Without any context there is no grounds to label this behaviour as bullying however several specific behaviours meet criteria for bullying if repeated over time and directed at this JMO (See Box 1).
Box 1: Five behaviours of bullying
- Destabilization - for example, disrupting another's performance by repeatedly reminding him or her of mistakes, creating stress or assigning meaningless tasks
- Isolation - for example, preventing access to or opportunities for training or deliberately withholding important work-related information
- Overwork - for example, setting impossible deadlines or disrupting another's work unnecessarily
- Threat to personal standing - for example, insulting or teasing another
- Threat to professional status - for example, publicly humiliating or accusing another of lack of effort
Adapted from Djurkovic, McCormack & Casimir, 2006
In 2, the SMO behaves in a respectful manner. His body language and facial expressions are supportive and non-threatening. His language is polite. He patiently waits for the JMO to respond and when it is apparent the JMO is struggling, he asks permission to provide support. In supporting the JMO, he reframes the task so that it is within the JMOs capability, thus empowering him to succeed with the diagnosis. He then thanks the JMO for attempting the task. As a result of his respectful interaction, he is able to assertively make a request that the JMO goes away and reads up on the topic. The JMO accepts this feedback in a positive manner. This is not just respectful behaviour, it is effective educational practice.