Bullying, Social Norms, and Reporting Behavior: A National Survey of Medical Training Programs.

Abstract

About half of medical residents report experiencing bullying behaviors in training settings, and these negative acts adversely impact the work environment in a variety of ways. Understanding perceptions of how often others report bullying behavior (descriptive norms) and how approving others are of these behaviors (injunctive norms) lays important groundwork for potential intervention studies in medical education. The primary aims of our study were to (a) examine the accuracy of descriptive and injunctive norms related to reporting bullying behaviors, and (b) determine whether individuals with larger self-other differences would be more likely to report bullying behaviors. We conducted exploratory analyses to examine associations between self-valuation (eg, self-compassion) and perceived risk of consequences of reporting bullying behavior. Our analyses also explored differences in perceptions of risk related to experiencing retaliation among women and those who identified as underrepresented in medicine. Data were gathered and analyzed as part of the 2024 Council of Academic Family Medicine Educational Research Alliance survey of family medicine educators and practicing physicians. Faculty and staff working in family medicine education (N = 1,096) tended to be inaccurate when estimating others' behaviors and beliefs about reporting behavior. Self-other differences predicted one's tendency to engage in reporting bullying behavior. Our study expanded on previous findings that suggested that those in medical education have inaccurate peer perceptions of attitudes and behaviors related to reporting bullying behavior. Further, our study provided additional support for studying the use of social norms interventions as a strategy to modify maladaptive perspectives and behaviors in this setting.