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1. How will I know if there is a problem with a trust in my deanery?

There are many ways in which issues with poor workplace behaviours such as bullying and undermining may come to light. Common methods are outlined below.

Before exploring these methods it is important to acknowledge that managing poor workplace behaviours can be a difficult undertaking, requiring sensitivity and confidentiality.

Trainees are often very concerned about the impact of reporting events on their ongoing training and future careers.  Reports may therefore be vague in an effort to preserve anonymity.

1. Training Evaluation Form (TEF)

The annual TEF survey is run by the RCOG and completed by all UK trainees in O&G.

It is a formal route for trainees to give direct feedback on their training and contains a section on workplace behaviour.

An advantage of the TEF is that feedback is confidential which may empower trainees to give more honest reports of bullying or undermining; however this limits the ability to follow up on reports with the individuals.

Other disadvantages of the TEF are that it is reported annually and there is a delay in obtaining the results, which may occur after affected trainees have left the department. It is particularly useful for monitoring chronic issues.

2. GMC National Training Survey

The annual GMC’s National Training Survey covers trainees in England only.  Its benefits and limitations are similar to the TEF.

3. Workplace Behaviour Champions

Trainees may contact local champions or your RCOG regional WPB champion, who may pass the information onto you. Regional WPB champions should attend and report any issues (keeping trainee names confidential) to regional school management board on a regular basis.

4. Deanery specific mechanisms

If you have a regular meeting with your trainees then this could be utilised to gather real-time verbal feedback.  In this situation, the feedback you obtain will be influenced by the make-up of the meeting panel, as trainees are likely to adjust their response if a member of their unit is present. Sadly trainees are sometimes reluctant to speak up to senior trainers as they fear this may affect their career progression which of course must not the case. Some deaneries run local surveys that can be utilised.

5. Individual trainees talking to you

As Head of School or Training Programme Director you may receive feedback on a one-to-one basis from trainees. This may be either by email or verbally. If the feedback is given verbally it is important to document this discussion in an email or written report which allows the trainee to review if the issues that they wish to highlight have been communicated appropriately.

6. Trainee representatives

Regional or local trainee representatives, such as via Junior Doctor Forums or regional trainee committees, may be the recipients of feedback on workplace behaviour.  They are also a potential mechanism for actively acquiring information on workplace behaviour in your units.  They can often collect real-time information on the effect of workplace behaviour on the quality of training and trainee wellbeing.

Consideration must be given to the fact that it can be hard for trainees to speak up about bullying or undermining in departments where they continue to work as there is concern about repercussions, either perceived or actual. There should, of course, not be any such repercussions and it is the role of senior educators to reiterate this and encourage open discussion.

Some regions have trainee representatives from each trust who meet regularly with Training Programme Directors or Heads of School to update them about training issues, workplace behaviours and the educational climate in each unit.

7. Word of mouth

The most difficult way that feedback can be gained is through word of mouth by those inside and outside of the department affected.

The difficulty raised here is that this may not come directly from individuals involved in a situation and may not be factual or accurate. However, it is important to explore the issue.

Options include approaching trainees for more information, for example through you trainee representative, or waiting for feedback through official channels as detailed above.