EDI Research in School of Medicine – Monthly blog

The School of Medicine hosts an array of teams performing critical research into EDI related issues. Here we host a monthly blog where we ask these researchers about their work, what inspired them and how they hope it will make a difference.

October 2025:

This month we are delighted to hear from Dr Elaine Burke, Assistant Professor in the Discipline of Medical Education, about her ongoing research of PlayDecide Teamwork, a discussion game for junior doctors to explore workplace bullying and harassment.

Co-authors: Declan Byrne, Mark Donegan, Oisín Hannigan, Julie O’Grady, Alice Waugh and Martina Hennessy

What does EDI in Medicine mean to you?

EDI is an important issue in Medicine – it’s about social justice and representation, but we also know that diverse perspectives enhance all aspects of our work, as doctors, scientists, and educators.  A true meritocracy is one that addresses inequity, so embracing EDI principles benefits us all.  Medicine as a profession can be quite traditional in some ways, with a strict hierarchy – but I believe most doctors and academics have a strong sense of fairness and social justice, so while there is still some work to be done, I’m very hopeful for the future!

Tell us a bit about your research:

This project was developed initially in response to a survey by the Irish Medical Council which found that almost half of interns (junior doctors in their first year of postgraduate clinical training) reported experiences of workplace bullying and harassment (WBH), with only a small number taking action to report the behaviour.  These findings highlighted a need to provide an educational intervention which would enable interns to identify the types of behaviours that constitute WBH, and the different supports available to help them address the issue.  This is important to protect and support junior doctors and ensure that they themselves don’t model these behaviours in the future.

Working with a multidisciplinary team based in St James’s Hospital, including colleagues from nursing, allied health and human resources, we used a freely available template called Play/Decide to develop a serious card-based discussion game.  Using story cards, interns discuss realistic scenarios which depict different behaviours ranging from positive teamwork to definite bullying or harassment, and the effects these behaviours can have on staff, students, patients, and family members.  They use info cards to help define the behaviour types and identify the supports that could be activated in each scenario.  When we piloted the game in St James’s Hospital, we got great feedback, so we applied for and were awarded funding from the HSE NDTP Development Fund to roll the game out to other intern networks around the country.

We have shared the game with three other intern networks nationally.  Feedback across all the sites from both interns and trainers was very positive - the interns found the game to be acceptable, the cards realistic and relevant, and they agreed that it was a safe space to discuss workplace issues. Trainers on all sites retained their own versions of the game so they could run sessions with interns in the future.

The success of this project is largely due to the multidisciplinary nature of the team who developed the game, and support of our hospital colleagues and colleagues in the Intern Network Executive, who reviewed the content, helped organize and facilitate trainer and intern sessions, and helped us collect feedback from the interns – emphasizing once again the importance of good teamwork!

Why are you passionate about this research topic?

The clinical workplace is a high-pressure environment and having worked in full-time clinical practice for a number of years, I’m very aware of how stressful it can be.  WBH and incivility can arise, and the impact on trainees may be significant.  However, most healthcare workers don’t set out to bully or harass their co-workers, it’s often a learned behaviour, and can be seen as an acceptable, even necessary, part of training.  There is a need to break this cycle, and education is the key.  Approaching the issue with understanding and empathy for both the target and bully, who may be modelling behaviours they themselves have experienced, is important.  Ultimately, this will help us sustain a clinical workplace that is harmonious, collegiate, and safe for clinicians and patients.

Why is equality, diversity and inclusion (EDI) an important aspect of this research?

Harassment refers to unwanted conduct on any of the 9 grounds of discrimination, which include gender, sexual orientation, age, disability, race, and membership of the Travelling community.  Harassment and sexual harassment create a degrading, intimidating, humiliating or offensive environment for the person who experiences it.  While anyone can experience WBH, groups who are under-represented in medicine may be more likely to be a target of some of these behaviours.  Eliminating WBH goes hand in hand with respecting equality, diversity, and inclusion.

How can the outcomes of your research improve EDI in medical research and/or education?

It’s probably a stretch to say that a single board game will change the culture of an institution! I would see it more as contributing to a conversation about how we talk to and treat each other, especially in high pressure environments.  Incivility, bullying and harassment have a real impact and shouldn’t be considered acceptable or normal in any workplace.  My hope is that this conversation brings us closer to understanding and eventually eliminating these behaviours.  At a time when voices of intolerance seem to be getting louder, these conversations become more important than ever.

For more information on the research of Dr Burke and her colleagues, see their recent publication here.