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Understanding how unprofessional behaviours between staff in acute care arise, whom they impact, and how they can be addressed: findings from a realist review – 15 November 2023

By 12th December 2023February 20th, 2024Previous Seminars


Dr Justin Aunger, Research Fellow, Midlands Patient Safety Research Collaboration


Unprofessional behaviour (UB) between staff encompasses various behaviours, including incivility, microaggressions, harassment, and bullying. It is pervasive in acute health care settings and disproportionately impacts minoritised staff. UB has detrimental effects on staff wellbeing, patient safety, and organisational resources. While interventions have been implemented to mitigate UB, there remains limited understanding of how and why they may work and for whom. Similarly, while contributors to these behaviours have been investigated, understanding of how they interact and how they can be targeted by interventions can be improved. To address these knowledge gaps, we performed a realist review, drawing on 148 literature sources and 42 reports of interventions, to better understand how these contributors lead to UB and worsening of its impacts. We also investigated when and how these complex, context-dependent interventions to reduce UB work. This presentation will explore our findings and present implementation guidance to help others address UB in the healthcare workplace in the future.


Dr. Justin Aunger is a researcher with a background in behavioural science applied at individual, team, and organisational levels. He is interested in addressing complex challenges in healthcare organisations and has recently worked on multiple projects drawing on realist methodology. This includes understanding how inter-organisational collaborations work, and how unprofessional behaviours between staff can be addressed. He has experience developing and delivering multiple kinds of research, including behaviour change interventions in a healthcare context, realist reviews and evaluations, and qualitative studies.

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