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Intraoperative behaviors survey

Consent script
You are invited to participate in a research study examining your exposure and responses to disruptive behavior in the operating room. We define disruptive intraoperative behaviors as those that undermine a reasonable person’s standard of respectful behavior. These behaviors range from mild incivility to egregious abuse. They are critical to study, since they can undermine the wellbeing of clinicians, the functioning of institutions, and the safety of patients. The way people respond to these behaviors is also critical since responses can ameliorate or exacerbate the negative effects of disruptive behavior.

This survey is being conducted by the Intraoperative Behaviors Research Group consisting of researchers from the University of the Fraser Valley (UFV), the University of Michigan, and several health regions across North America. It has been approved by the UFV research ethics board. This group previously conducted the largest survey study on the topic (involving ~7500 clinician responses across 7 countries), which resulted in many original peer-reviewed articles and several invited reviews.
Your participation in this research study is completely voluntary. The procedure involves completing a questionnaire assessing exposure and responses to disruptive intraoperative behavior. It will take approximately 15 minutes to complete. Upon participating, you may withdraw at any time by not completing the remainder of the survey. Your responses will be anonymous, and we will not link them to any directly identifying information such as your name, email address or IP address (if completing this questionnaire online). Efforts to safeguard your confidentiality are in place. All data will be stored in a password-protected, electronic format. The data from this study will be discussed and presented in composite form in any resulting presentations or publications. Data access will be limited to the main study investigators and the UFV research ethics board. However, absolute confidentiality cannot be guaranteed. To help safeguard your confidentiality, please do not write your name or identifying information on this survey or in any textboxes.

The risks of participating are minimal, but some questions may prompt you to recall uncomfortable or distressing experiences. If you are experiencing distress due to exposure to disruptive behavior, we encourage you to consult the mental resources appended to this consent script (based on your geographical location). There may be no direct benefit to you for participating in this study. However, the information you provide will be useful in identifying institutional factors that affect exposure and responses to disruptive intraoperative behaviors.

Once you have completed the survey, you will have the option of entering yourself into a draw for a MacBook Air (pending correctly answering a skill-testing question). The value of the MacBook air is approximately $1300 CAD. The odds of winning will depend on the number of participants who chose to take part in the draw, but we conservatively estimate that the odds will be 1/1000 (min ~465 participants, but given the number of associations being contacted, a target sample of 1000 is our target). This requires disclosing some personal contact information. However, the responses you give to that ballot are not connected to your answers to the main survey. The probability of winning depends on the final number of total respondents. Note: please do not complete this survey more than once, as individuals with duplicate entries will be precluded from the draw. By completing this survey, you agree to participate. Thank you for your time and effort!
Free mental health resources:

Canada: https://www.canada.ca/en/public-health/services/mental-health-services/mental-health-get-help.html
USA: https://www.nimh.nih.gov/health/find-help
New Zealand: https://www.health.govt.nz/your-health/services-and-support/health-care-services/mental-health-services/mental-health-and-wellbeing-where-get-help
UK: https://www.mentalhealth.org.uk/explore-mental-health/get-help
Australia: https://mhaustralia.org/need-help
South Africa: https://www.sadag.org/
1.To help us keep track of our response rate, please select the perioperative organization that directed you toward this questionnaire:
A. The next section focuses on disruptive behaviors that you may have personally experienced in the operating room.
2.While in the operating room this past year, I have:
Never  (0)
1-2 times per year (1)
Every few months (2)
Every month (3)
Every week (4)
Every few days (5)
At least once per day (6)
Been insulted
Had hurtful sarcasm directed towards me
Had my work obstructed by colleagues
Had my competency questioned
Been discriminated against based on my gender, race, or ethnicity
Been inappropriately pressured to change my clinical care
Had my work unfairly criticized
Had insults directed toward me
Been ignored by others
3.Workplace bullying is a pattern of exposure to disruptive behaviors. We define workplace bullying as a work situation where a person sees themself as the recipient of recurrent disruptive behaviors by one or more people with a clear intent to harm, accompanied by difficulty in defending themselves against these actions.
Based on the above definition, in the past year how often have you:
Never  (0)
A few times per year (1)
Every few months (2)
Every month  (3)
Every week (4)
Every few days (5)
At least once per day (6)
Been bullied in the operating room?
The next section focuses on disruptive behaviors that you have witnessed in the operating room.
4.Over the course of your ENTIRE CAREER, have you ever seen the following actions in the operating room:
Yes
No
A clinician physically assaulting another clinician
A clinician verbally threatening another clinician
A clinician throwing an object at another clinician
A clinician invading the space of another clinician to intimidate them
5.While in the OR this past year, I have observed a member of my profession:
Never  (0)
A few times per year (1)
Every few months (2)
Every month  (3)
Every week (4)
Every few days (5)
At least once per day (6)
Having their input into a patient’s medical care rudely dismissed
Have hurtful sarcasm directed towards them
Having their work obstructed by colleagues
6.While in the OR this past year, I have observed someone:
Never  (0)
A few times per year (1)
Every few months (2)
Every month  (3)
Every week (4)
Every few days (5)
At least once per day (6)
Speak ill of others in their absence
Use language offensive to others
Disparage other medical professions
7.While in the OR this past year, I have observed a patient (whether conscious, sedated, or anesthetized):
Never  (0)
A few times per year (1)
Every few months (2)
Every month  (3)
Every week (4)
Every few days (5)
At least once per day (6)
 Subjected to disrespectful comments about their health state
 Subjected to inappropriate comments about their physical appearance
8.While in the OR this past year, I have observed others (not in my profession):
Never  (0)
A few times per year (1)
Every few months (2)
Every month  (3)
Every week (4)
Every few days (5)
At least once per day (6)
Having their input into a patient’s medical care rudely dismissed
Have hurtful sarcasm directed towards them
Having their work undermined by colleagues
Now we would like to know about the actions you recently took in response to disruptive behavior.
9.In response to being exposed to disruptive intraoperative behaviors in the last year, I have:
Never  (0)
A few times per year (1)
Every few months (2)
Every month  (3)
Every week (4)
Every few days (5)
At least once per day (6)
Kept quiet even though I was upset.
Acted as though the behavior had not occurred.
Accepted the behavior as part of the operating room culture.
Tried to appease the offender by altering my medical care.
Avoided communicating with members of the operating team.
Attempted to find a beneficial solution that prevented the behavior.
Attempted to change the behavior so it would become beneficial to all parties.
Attempted to find a beneficial alternative to the behavior.
Tried to turn others against the offender.
Worked less efficiently to try and anger the offender.
Misled the offender in some way to avoid further issues.
Used physical force with the offender.
Supported the behavior in order to “teach the victim a lesson.”
 Told the offender that I would make life difficult if they continued
YOU ARE DOING GREAT! KEEP GOING!
Next, we would like to know about the culture in your operating rooms (i.e., the "clinical area").
10.To what degree do you agree or disagree with the following statements?
Disagree strongly (1)
Disagree slightly (2)
Neutral (3)
Agree slightly (4)
Agree strongly (5)
Not applicable
Nurse input is well received in this clinical area.
In this clinical area, it is difficult to speak up if I perceive a problem with patient care.
Disagreements in this clinical area are resolved appropriately (i.e., not who is right, but what is best for the patient).
I have the support I need from other personnel to care for patients.
It is easy for personnel here to ask questions when there is something that they do not understand.
The physicians and nurses here work together as a well-coordinated team.
I would feel safe being treated here as a patient.
Medical errors are handled appropriately in this clinical area.
I know the proper channels to direct questions regarding patient safety in this clinical area.
I receive appropriate feedback about my performance.
In this clinical area, it is difficult to discuss errors.
I am encouraged by my colleagues to report any patient safety concerns I may have.
The culture in this clinical area makes it easy to learn from the errors of others.
My suggestions about safety would be acted upon if I expressed them to management.
Next, please tell us about the working conditions in your operating rooms.
11.To what degree do you agree or disagree with the following statements?
Disagree strongly (1)
Disagree slightly (2)
Neutral (3)
Agree slightly (4)
Agree strongly (5)
Not applicable
The layout of our operating rooms provides enough space to ensure unencumbered movement.
The necessary resources are available in adequate amounts in our operating rooms.
Equipment is available and functioning properly in the operating room.
The operating room environment (lighting, temperature, noise level) is conducive to concentration and performance.
Procedures in the operating room are typically scheduled in an efficient way that minimizes patient wait lists.
I am not paying attention to the answers I am giving (just making sure you are paying attention!)
Staffing levels in the operating room are sufficient to handle the workload.
Patient flow into and out of the operating room is managed without unnecessary delays.
Staff rotation in the operating room is managed to ensure uninterrupted staffing.
Break schedules in the operating room are managed to reduce fatigue among staff.
There is strict adherence to sterilization and infection control protocols in our operating rooms.
Staff have the combined experience, training, and skill to deal with the degree of complexity we see in our patient cases.
Turn-over time between cases is managed efficiently.
Specialized expertise is readily available when a case becomes complicated.
Staff receive ongoing training in new surgical techniques.
12.Just checking to make sure you are not a bot- How many dogs are in the above collage photo (use numeric characters only, with no leading or training spaces):
ALMOST FINISHED!
Next, please tell us more about yourself.
13.I see myself as someone who …
Disagree strongly (1)
Disagree a little (2)
Neither agree nor disagree (3)
Agree a little (4)
Agree strongly (5)
 … is reserved
 … is generally trusting
… tends to be lazy
 … is relaxed, handles stress well
… has few artistic interests
 … is outgoing, sociable
 … tends to find fault with others
… does a thorough job
 … gets nervous easily
… has an active imagination
14.Age (years):
15.Biological Sex:
16.Gender:
17.Member of a visible racial/ethnic minority group relative to your context:
18.My country of employment is:
19.I work in the following healthcare settings:
20.My profession is:
21.Randomized offer: You have now completed the main survey. Would you like to take part in our substudy looking at reporting disruptive behaviour and turnover intentions? If you do, we will QUADRUPLE your chances of winning the prizes.
Current Progress,
0 of 36 answered