Do anti-bullying programs work in surgery? What surgeons think

What is it about?

This study examines how surgeons perceive and experience formal anti-bullying training in surgical workplaces, with a particular focus on whether such programs are seen as meaningful, credible, and capable of driving real change. It draws on the views of surgeons across Australia and Aotearoa New Zealand who have participated in structured anti-bullying initiatives designed to promote respectful behaviour and improve workplace culture. Anti-bullying training has become an increasingly common response to concerns about professionalism, wellbeing, and safety in healthcare. Yet there is limited evidence about how these programs are received by senior clinicians, or whether they are experienced as transformative or merely symbolic. This study addresses that gap by exploring surgeons’ own reflections on the purpose, impact, and limitations of anti-bullying training within the realities of surgical practice. Through qualitative interviews and survey-based feedback, surgeons shared candid views about what worked, what did not, and why. Many participants welcomed the intent behind such programs and acknowledged the importance of explicitly naming bullying behaviours that had long been normalised. Some described training as providing a shared language, legitimising previously unspoken concerns, and signalling that professional standards were beginning to shift. At the same time, surgeons expressed scepticism about the capacity of training alone to change deeply entrenched behaviours. Participants highlighted tensions between formal messaging and everyday workplace realities, particularly in environments shaped by hierarchy, time pressure, and informal power. Several noted that training could feel disconnected from actual consequences, especially when senior figures were perceived as exempt from scrutiny or accountability. The study also explores how anti-bullying initiatives are interpreted differently depending on career stage, leadership role, and organisational context. Surgeons reflected on the importance of visible leadership support, consistent follow-through, and alignment between stated values and lived practice. Without these conditions, training risked being seen as a compliance exercise rather than a catalyst for cultural change. Importantly, this paper does not position anti-bullying training as ineffective or futile. Instead, it offers a nuanced account of how such programs are experienced from within the profession they seek to influence. By centring surgeons’ perspectives, the study identifies both the promise and the limits of training-based interventions, and highlights the conditions under which they are most likely to contribute to safer, more respectful surgical workplaces. Overall, the paper provides practical insight into why some anti-bullying initiatives gain traction while others stall, and why lasting change in surgery requires training to be embedded within broader leadership, governance, and cultural reform.

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Photo by JAFAR AHMED on Unsplash

Photo by JAFAR AHMED on Unsplash

Why is it important?

Anti-bullying training is now a central feature of many efforts to improve culture and professionalism in healthcare. Considerable time, funding, and institutional goodwill are invested in these programs, yet there is surprisingly little evidence about how they are experienced by senior clinicians or whether they are perceived as capable of changing real behaviour. This study is important because it addresses that gap directly. By examining surgeons’ perceptions of anti-bullying training, the paper moves beyond measuring attendance or satisfaction and instead explores whether training resonates with those who hold cultural and professional influence within surgical workplaces. Senior surgeons play a pivotal role in shaping norms, modelling behaviour, and determining what is tolerated in day-to-day practice. Understanding how they interpret and respond to training is therefore critical to assessing whether such interventions can deliver more than symbolic change. The findings highlight a crucial insight. Training can raise awareness, provide a shared language, and signal institutional intent, but it is unlikely to succeed in isolation. Surgeons consistently pointed to the importance of visible leadership commitment, alignment between training messages and organisational action, and credible consequences for harmful behaviour. Where these elements were absent, training was often experienced as disconnected from reality or reduced to a compliance exercise. This paper is also important because it challenges the assumption that resistance to anti-bullying initiatives reflects individual defensiveness or professional arrogance. Instead, it shows that scepticism often arises from practical experience. Participants questioned whether training could overcome entrenched hierarchies, informal power structures, and longstanding cultural norms without broader structural reform. These reflections provide valuable guidance for organisations seeking to design interventions that are both credible and sustainable. By grounding its analysis in surgeons’ lived experience, the study offers a more realistic understanding of how culture change occurs in high-pressure, high-status professions. It demonstrates that anti-bullying training is most effective when embedded within a wider system of governance, leadership accountability, and cultural reinforcement. Ultimately, this paper matters because it helps organisations move from good intentions to informed action. It clarifies what training can and cannot achieve on its own, and provides evidence-based direction for designing interventions that are more likely to improve behaviour, strengthen psychological safety, and protect both staff wellbeing and patient care.

Perspectives