Aim: Healthcare systems currently experience widespread unprofessional behavior, with staff burnout being one of the main outcomes (Westbrook et al., 2018). This study proposed and tested a moderated mediation model explaining burnout in medical students whereby incivility was defined as an identity threat that increases burnout via a reduction in identity salience (motivation). Resilience and career entrenchment (i.e., feeling that career change is difficult due to having substantial economic and psychological investments in that career) were included as moderators.

Design: Cross-sectional analysis of data obtained from one of five waves of a longitudinal cohort study.

Method: Participants were 115 medical students. All variables were assessed in the final (5th) year of study using validated scales. Moderated regression analyses and the Hayes process software were used to test the model. Results: Experiencing workplace incivility was associated with more doubts about being a doctor and this effect was stronger amongst medical students with lower resilience. More doubt (low identity salience) was associated with higher burnout. Career entrapment did not moderate this relationship. Incivility had an indirect effect on burnout via identity for those with low resilience but also had a significant direct effect.

Conclusion: The findings of this study support the moderated mediation model to explain how incivility can impact burnout. Understanding the extent to which these effects remain the same as a medical student transitions into hospital-based practice is important. Similarly, the effect of career entrenchment may surface more strongly once an individual’s ‘actual career’ begins post-graduation. Obtaining a clearer picture on the various workplace and person-specific factors that influence burnout across the medical career pathway can better inform interventions to address what is increasingly recognised as a serious problem.

Issue: Accurate and timely reporting of safety incidents is a crucial component of a positive culture. These invaluable learning opportunities allow us to adapt, make improvements and prevent future injury. But how can an organisation, team or individual learn and improve when incidents – both physical and mental – are not reported or captured?

Approach: We analysed our cultural diagnostic data across a range of industries and organisations to understand how prevalent underreporting of incidents was, and more importantly; what the key underlying drivers were – something that had not sufficiently been done in the literature, and even less so in practice. This case study report encompassed practice-lead data across 12,460 participants and was recently published in late 2018.

Key Findings: Our recent Australian data highlighted that on average, 31% of incidents go unreported and in some organisations this figure rises as high as 53%. That’s a lot of missed opportunities to improve culture. This study provided a number of key results, including: (1) Underreporting rates across team, frontline leader, and senior leader levels, (2) The three key drivers of underreporting: Underappreciation, Fear, and Process factors; (3) The influence of safety culture maturity on underreporting; and (4) The link between safety climate and underreporting.

Implications: For organisations across multiple industries, whether consulting internally or externally – our comprehensive case study provided a number of implications that delegates to the IOP Conference should be across, including: (1) An understanding of the current underreporting rate in high-risk industries across different organisational levels and the implications of such; (2) The three key drivers of underreporting and how these could be driving underreporting within an organisation; (3) An understanding of how an organisation’s safety culture maturity could be influencing underreporting rates; and (4) The link between various dimensions of safety climate and underreporting, with an emphasis on error management climate.

Conclusions: High underreporting rates within an organisation means missed opportunities to improve and learn from mistakes. Exploring the drivers of underreporting, and understanding the cultural and climate factors that may influence underreporting can help you to create a workplace culture where mistakes and incidents are shared, discussed, and prevented from occurring again. This moves to create a strong positive culture, and not just in safety.

Background: In the workplace aggression literature the focus of research is usually a single construct such as bullying, harassment, incivility, or abusive supervision. While researchers tend to acknowledge that there is some commonality between constructs, they have focused on the characteristics and measures of individual constructs at the expense of theorizing common ground between them. A few researchers have investigated the relationship of one construct to another. For instance, Lim and Cortina (2005) investigated the relationship between incivility, gender harassment and sexualized harassment by collecting self report data from US federal court employees. They found that these behaviors frequently co-occurred. Lim and Cortina conclude that the effects of mistreatment are cumulative across constructs, and that aggressors may instigate multiple forms of mistreatment, both general and sexual. Focus on a single construct can lead to flaws in theorizing, such as under-estimating the incidence of mistreatment generally or over ascribing negative influence to a single construct when in fact there are multiple sources of negative influence from different types of workplace aggression. Hershcovis (2011) undertook a qualitative review of abusive supervision, bullying, incivility, social undermining, and interpersonal conflict to identify overlapping and differentiating elements of these constructs. She concluded that key differentiating elements of social undermining are not measured, and that while the five mistreatment constructs had distinctive definitions, the way workplace aggression constructs are differentiated in the literature did not add meaningfully to our understanding of workplace aggression’ (Hershcovis 2011, p. 49).

In summary while there is concern about construct proliferation and co-occurrence of different types of workplace aggression, the nature of the commonality among different types of workplace aggression is a gap in the literature. The current research is an initial exploration of these issues. Aim: The aim of this paper is to explore the principles and theories embedded in current measures of interpersonal mistreatment in organizations. The initial research question is, ‘To what extent are different constructs of interpersonal mistreatment in the workplace defining and measuring a common idea?’ Alternatively, what is the evidence for these four constructs being discrete to each other?

Design and Method: Four constructs were chosen to include in a latent thematic analysis: abusive supervision, workplace bullying, incivility and ostracism. The analysis was limited to four constructs to keep it to a manageable size. Construct selection was based on literature citation and that each had a reliable behavioural scale to measure it. The four papers were Tepper’s (2000) identification of abusive supervision measured by the Abusive Supervision Scale; Einarsen, Hoel and Notelaers’ (2009) work on workplace bullying, measured by the Negative Acts Questionnaire; Cortina, Magley, Williams, and Langhout (2001) work on incivility measured by the Workplace Incivility Scale; and Ferris, Brown, Berry, and Lian’s (2008) identification of ostracism measured by the Workplace Ostracism Scale.

Results: There is evidence of substantial common ground between these four constructs. (1) The behavioral items across the constructs share common content and tactics (ways of performing the behaviours). (2) The definitions and explanations share theoretical ground on power, ambiguity of intent, and the nomological net used for construct validation. (3) The constructs share unresolved issues; the use of harm as proof of the workplace aggression taking place, that the authors’ discussions modify the definitions in a way that increased the commonality between them, and that co-occurrence between abusive supervision, workplace bullying, incivility and ostracism is not explored.

Conclusion: This research identifies a common foundation between abusive supervision, workplace bullying, incivility, and ostracism. The behavioural scales used to measure these constructs share common behaviours and tactics. The constructs share a common nomonological net, and theoretically the definitions overlap each other. In this paper this common foundation is referred to as ‘workplace aggression’ or ‘interpersonal mistreatment’. The fact that only four constructs were included in the analysis is a limitation of the study. Other combinations of interpersonal mistreatment – such as including sexualized mistreatment, or cyber mistreatment – may demonstrate clearer distinctions between constructs. Implications: The findings of this research inform discussions in the literature about co-occurrence and construct proliferation by investigating the theoretical relationship between multiple constructs and the scales used to measure them. Research that focuses on a single construct of workplace aggression risks overstating the uniqueness of that construct and exaggerating the incidence and impact of that single construct. Organisational interventions that focus on a single construct may be ineffective or have unintended consequences if there is more than one construct contributing to workplace aggression. Theorising and measuring workplace aggression needs to acknowledge and assess the common ground between constructs. For these reasons, future research should consider using multiple behavioural scales, or combining behavioural scales to measure multiple types of interpersonal mistreatment in the workplace, rather than focusing on one to the exclusion of others.

Aims: This research addresses safety research literature concerns regarding failures of intervention implementation, and more particularly of sustainability, by identifying factors that impede and/or facilitate implementation success and the procedures required for sustaining interventions over the longer term. A further practical aim was to develop a coherent and transferable methodology for implementing and sustaining changes to address work safety concerns that can be applied across industry sectors.

Background A study of disability support workers’ (DSWs) psychosocial work safety showed DSWs experienced poorer health, wellbeing, and safety outcomes than norm groups. Causal factors were complex, with a number of safety interventions derived from stakeholder feedback recommended. Subsequently, seven work safety recommendations designed to address DSW psychosocial work safety were translated into practice and evaluated. Findings showed favourable psychosocial outcomes including improved health, wellbeing, and safety climate trends compared to pre-intervention. In particular, at post-intervention DSWs indicated significantly less concerns about psychosocial hazards compared with no change evident for physical hazard concerns, which were not targeted in the interventions. While the findings of this study supported the importance of factors that contribute to successful change implementation (e.g., overt management commitment; designation of ‘change champions’ to facilitate changes and remove obstacles; and user involvement and ownership of the process), much less was known in the research literature about the factors that would influence the ongoing sustainability of changes after successful implementation, with research evidence in the literature reporting organisational change failure rates ranging from 28%- 93% (average 73%), hence suggesting poor cost-benefit outcomes (Decker et al., 2012). Thus, this follow-up safety study was undertaken to understand the key factors associated with the successful implementation, maintenance, and sustainability of work safety interventions.

Method: Semi-structured interviews and focus groups were used on three occasions to follow-up with key stakeholders on the seven implemented safety interventions and identify factors facilitating or hindering the maintenance and sustainability of the interventions. Participants included: managers (n=24), shift supervisors (n=10), work health and safety personnel (n= 22), human resource personnel (n=2), and corporate support personnel (n=3). Interviews were used to determine the maturity level of the implemented interventions; the key factors facilitating and/or hindering intervention progress; and recommendations for facilitating the ongoing implementation, maintenance, and future sustainability of the safety interventions.

Results: Stakeholder interviews identified facilitators, hindrances and potential risk factors for the seven work safety interventions. Factors were conceptualised as 1) innovation attributes; 2) implementation process characteristics; 3) leadership behaviours and characteristics; and 4) organisational context (internal and external). Facilitating factors were spread across these four categories. At interviews completed at the conclusion of the research, facilitators were largely Contextual factors, particularly involving organisational characteristics (e.g., organisational infrastructure supports the innovation, organisational policies and procedures support the innovation, ongoing training for the innovation, and the presence of effective intra-organisational relationships) and the organisational culture (e.g., innovation contributes to a positive organisational culture and the organisational culture is receptive to changes and continuous improvement). Sustainability hindrances were also associated with the factor categories of innovation, process, and contexts, with no issues associated with leadership identified as hindrances in this study. In some circumstances hindering factors included the absence or shortage of the same factors identified as facilitators for other interventions. Stakeholders also noted certain risk factors as potentially hindering future sustainability of interventions (e.g., socio-political change). This investigation also demonstrated that there was a degree of overlap between factors and that intervention sustainability could be affected by the interaction of factors.

Conclusion: Findings suggested no ‘one size fits all’ approach to factors critical for maintaining and sustaining all changes. Rather, sustainability results from an interplay between key influential factors, the relative importance of which varies across change programs and over the course of the change implementation. At the broadest level, the key influential sustainability factors include attributes of the innovation; characteristics of the implementation process; leadership behaviours and characteristics; and the operational context. Context needs to be considered in terms of the external context (e.g. external conditions, threats/opportunities, social norms, stability, and fiscal environment) and internal context (including the organisational culture, political influences, financial and other resources, and characteristics of the organisation and workforce). To optimize benefits and sustainability, managers and change leaders should analyse the facilitators and/or hindrances for influential sustainability factors using the provided framework for each change or innovation. This analysis should occur before implementation and during the change process. Managers and/or change leaders should use the sustainability factor framework to consider and address risks that may threaten the implementation, maintenance and sustainability of changes. This research particularly demonstrated the importance of effective Champions of Change, not only for implementing changes but also to facilitate the maintenance and sustainability of changes. These champions serve to drive changes, ensure resources are allocated to achieve them, and work to unblock barriers that threaten their implementation and sustainability.