Research suggests “speaking up” could improve professionalism in healthcare.

Hospital staff who say they have strong “speaking-up” skills tend to experience less incivility and bullying from their colleagues, a new study shows.

The experts behind the study say that training in speaking up would help eliminate unprofessional behaviour.

Researchers surveyed over 5,000 staff members. They found 93.6 per cent reported experiencing at least one unprofessional behaviour during the preceding year. Of this group, 38.8 per cent reported weekly or more frequent incivility or bullying, 14.5 per cent reported extreme unprofessional behaviour.

Nurses and non-clinical staff members aged 25 to 34 years reported incivility/bullying and extreme behaviour more often than other staff and age groups respectively.

Staff with self-reported speaking-up skills experienced less incivility/bullying and extreme behaviour, and also less frequently an impact on their personal wellbeing.

“An important new finding was the strong association between self-assessed speaking-up skills and experiencing unprofessional behaviour,” wrote the authors.

“Respondents who reported having such skills were 47 per cent less likely to report frequent experience of incivility or bullying and 20 per cent less likely to report extreme unprofessional behaviour from co-workers than colleagues without these skills.

“Reporting speaking-up skills was also strongly associated with lower rates of reporting of negative impacts on personal wellbeing, teamwork, and quality indicators.

“Health systems in several countries have invested in speaking-up programs, reflecting the expectation that they will reduce the frequency of unprofessional behaviour.

“That having speaking-up skills reduces the frequency and impact of unprofessional behaviour, as suggested by our results, is therefore plausible.

“The effective elements in these programs need to be identified, as well as factors that support their sustainability and scalability, including the organisational context in which staff are asked to speak up.

“We also found that being comfortable about reporting unprofessional behaviour was significantly associated with staff perceptions of the organisational culture, the effectiveness of their hospital in managing complaints about unprofessional behaviour, and the likely consequences of reporting; staff who believed they would be taken seriously were three times more likely to report bad behaviour,” the researchers said.

“Training hospital leaders in how to engage with colleagues to counter disruptive and unprofessional behaviour is critical, including being receptive when staff speak up, and having both the skills and processes for an effective response.”

The study is accessible here.