Workplace bullying in surgery: exploring the drivers and mitigators

This study investigates the drivers and mitigators of workplace bullying in surgical environments in Australia and Aotearoa New Zealand, utilizing social identity theory (SIT) and contemporary models of psychological safety. It introduces the concept of personality traits as a bridging factor between drivers and mitigators.

Qualitative interviews were conducted with 31 surgeons. Thematic analysis, supported by NVivo, was used to map findings to the SIT framework and incorporate psychological safety and personality theory.

Key drivers of workplace bullying include entrenched hierarchical power structures, gender dynamics and early socialization in competitive environments. The "bad apple" phenomenon, where personality traits such as narcissism and low emotional intelligence exacerbate bullying, contrasts with individuals demonstrating empathy and interpersonal awareness, who mitigate such behaviors. Effective leadership, generational shifts and team stability through procedural inclusion are key mitigators that promote psychological safety and collaboration.

Sample diversity, self-reporting bias and temporal context may impact the generalizability of findings across broader health and surgical settings in contemporary practice.

Addressing entrenched power imbalances and fostering inclusive leadership and practices are critical to mitigating bullying. Promoting psychological safety and leveraging generational change can reshape surgical culture, leading to healthier teams and improved patient outcomes.

This study bridges SIT with theories of personality and psychological safety, offering new perspectives on how individual traits and systemic dynamics shape bullying behaviors and culture in surgical teams, highlighting the need for targeted interventions.