RCOG World Congress 2023

The GRACE Movement – to improve workplace civility in Obstetrics and Gynaecology

Objective

•GMC National Training survey (2014): O&G trainees reported more undermining behaviour than other specialties

•RCOG recognized bullying and undermining increases attrition from O&G trainings.

•Interventions aimed at preventing bullying are often “top down” approach; evidence of effectiveness is of low quality.

AIM: To empower O&G residents for a “ground up” approach to improve workplace civility.

Methods - THE GRACE MOVEMENT

Gratitude/gracious words

Respect for all, regardless of rank

Awareness (self/situational)

Compssion, for self and others

Empathy

•Survey was conducted among O&G residents regarding their knowledge & perception of workplace incivility

•Introduction of the concept of workplace incivility and GRACE movement was introduced at one of the compulsory residents weekly teaching over Zoom

•Residents were encouraged for self reflection before splitting into groups of mixed seniority for group discussion

•Encouraged to formulate proposal on potential interventions according to the GRACE movement concept to reduce workplace incivility

•Their Quality Improvement (QI) proposals were pitched to a panel of senior clinicians including Residency Program Director and Associate Program Directors, Division Chairperson and Education Chair

•The best proposal won the chance of implementation over the coming year

Results

•Talk was effective in evoking reflection and discussion on workplace incivility among the residents

•Majority of the residents were more aware of this topic and believed in the importance of their individual roles to the GRACE movement

•The breakout group brainstorming segment was the most enjoyed

•The QI project pitching was thoroughly enjoyed by residents

•They felt that they learnt more regarding workplace incivility and felt encouraged and motivated to improve workplace incivility through listening to their friends’ ideas

•However, many also raised concerns regarding the actualization of the projects and if the senior doctors will be involved in the implementation to improve workplace incivility

•Many also sounded jaded that this would only be additional work instead of being able to make a difference

Conclusion

•This was an effective exercise in rising awareness of workplace incivility and encouraging residents to initiate potential interventions to improve workplace incivility.

•Changes are often met with resistance. Persistence and innovative methods to encourage change is required

•More senior doctors can be included in the next exercise to increase the effectiveness

RCOG World Congress 2023

The GRACE Movement – to improve workplace civility in Obstetrics and Gynaecology

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