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Mr Kareem Marwan, General and Colorectal Surgeon at Knox Private Hospital, shares his five top learnings from the Building Respect training.

As a surgeon and a trainer, I've valued the opportunity to complete two training courses as part of the Let's Operate with Respect campaign to build respect and increase patient safety in surgery.

The courses are:

  1. The Operating with Respect Online Module, which provides knowledge and understanding of unacceptable behaviours so they can be recognised when they occur. It's delivered online, takes 45 minutes and is a mandatory part of CPD requirements for 2017.

  2. The Foundations Skills for Surgical Educators (FSSE) course, that gives expanded knowledge and skills in surgical teaching and education techniques. It's delivered face-to-face and is mandatory for all who teach or train SET trainees or supervise IMGs.

I've taken some key learnings from these courses, including those below, and would recommend them to all surgeons.

  1. It is everyone's responsibility to report unacceptable behaviour
    We all have a responsibility to report unacceptable behaviour in the workplace, no matter our title. The Operating with Respect online module provides a great overview of the way bullying, discrimination and sexual harassment has impacted our profession, and shows clearly why we need to keep working to address it. From our position as leaders, surgeons have a responsibility to lead the charge.

  2. We must respect everyone around us
    From our Trainees, to nurses, to registrars and first and foremost, our patients, we must show them respect. Historically, our work culture has been as surgeons, ordering others around and taking a hierarchical approach to the workplace. The Operating with Respect course teaches us we must all come together and work cohesively. We all have the right to a workplace free of discrimination, bullying and sexual harassment.

  3. As teachers, we need to give constructive and effective feedback
    It's easy for Trainees or IMGs to feel intimidated. They look up to surgeons and can feel vulnerable in the learning environment. At the same time however, they need to fulfil certain criteria in the training program, so it's important they receive timely, honest and tactful feedback on their performance. If feedback is withheld or conveyed in a belittling manner, it can be destructive, so we need to ensure feedback is constructive and helpful. Trainees or IMGs should never be made to feel threatened or unsafe in the workplace.

    It's important to set aside time for providing feedback to your Trainees as close to the direct observation of practice as possible. We have a responsibility to our Trainees to mentor them.

  4. Effective communication is crucial for patient safety
    Two-way communication needs to be effective to care for the patient. The Trainee is there to learn and if they don't know what they're doing wrong, they have no way of improving. If a Trainee is doing something right, provide them with positive reinforcement. We cannot do our work without the support of our team, so be direct and specific. By creating a respectful workplace, we create an environment where everyone is comfortable to speak up and create a dialogue and that leads to better patient outcomes.

  5. We're on a journey
    As teachers, we must remember that we are all human and we do have weak and vulnerable moments. High standards of behaviour, in and out of theatre, are expected of us as surgeons. That means showing respect and calling out unacceptable behaviour.

The Let's Operate with Respect campaign offers the opportunity for us to work together to ensure all of us - consultant surgeons, Trainees and International Medical Graduates - are working as a team, driving the best in patient outcomes.

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