VICTORIA LISTER
Unravelling the hard-to-unravel ...
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CURRENT RESEARCH
MEDICAL PROFESSIONAL SILENCE
Understanding the forces that prevent junior doctors from speaking up at work
Victoria is an early career researcher at Griffith Business School, Griffith University in Brisbane, Australia.
Her PhD research aims to understand the forces that prevent junior doctors from speaking up at work. It draws on employee voice and silence theory viewed through an employment relations/human resources (ER/HR) lens, approaching workplace issues from the perspective of organisations and employees. This brings a focus to medical professionals' silence in relation to their working conditions as well as patient safety and care, enabling both to be equally considered and addressed.
As it has recently been proposed that the relationship between working conditions voice and patient safety voice is a reciprocal one – and both types of voice independently and jointly lead to positive patient outcomes – understanding what impedes each is important.
However in the quest to resolve the persistent and dangerous problem of medical professionals’ silence on matters of patient safety and care, medical professionals’ silence in relation to their working conditions is overlooked. Whilst understandable, this misses an important piece of the puzzle.
The project is grounded in employee voice and silence theory from the business discipline, draws on research on speaking up from the health discipline, and on professions from the sociology domain.
Understanding the role occupation – in this case that of medical professional – plays in creating junior doctors’ silence is of particular interest. A journal article based on a comprehensive review of the literature is underway. This examines what is known about professionals, voice and silence and contributes to employee voice and silence theory.
Early findings from the data
The research explores the experiences of junior doctors, a cohort especially vulnerable to silence and silencing. 38 interviews were conducted with junior doctors, senior doctors and stakeholders.
Early findings indicate a complex array of often powerful professional, organisational and individual forces related to being a medical professional can lead to silence on working conditions and patient safety and care. These include:
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entrenched professional norms that position junior doctors at the bottom of a hierarchy where they are to be seen but not heard
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hospital, departmental and specialisation cultures that ensure same
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professional discourse that emphasises overwork and non-complaint
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a culture of teaching by humiliation in which they are afraid to voice
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dependence on senior doctor supervisors for career progression and jobs
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training organisations that fail to address workplace issues
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hospitals that rely on unpaid labour
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opaque HR systems that elide formal voicing of complaints
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junior doctors who enter hospitals with little understanding of how to navigate complex organisational systems, and
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individuals whose commitment to or desire to succeed in their profession leads to either self-sacrificing or patient safety silence or, frequently, both.
Research impact
Understanding barriers to voice is critical in the healthcare context. This research will benefit individual medical professionals by enabling the bodies that educate, train and employ medical professionals to better support them – and by doing so, meet organisational goals by enhancing the quality of patient outcomes. This is increasingly important as community awareness of compromises to patient safety and care grows, especially those resulting from junior doctors’ working conditions.
Post-PhD, Victoria will focus on disseminating her findings via additional journal articles and other media to ensure it reaches academic, industry and mainstream audiences. Future research will examine this problem in more detail and identify interventions.
UPCOMING PROJECTS
Victoria is also passionate about the wellbeing of another kind of junior doctor: those in the process of obtaining a PhD or who are working post-PhD as early career academics (ECAs) in university settings.
To this end she undertakes several roles representing the interests of higher degree by research (Master by Research/Master of Philosophy and PhD) students at Griffith University and ANZAM (the Australian & New Zealand Academy of Management). In her spare time, she is investigating how the process of becoming an academic impacts ECAs’ mental health, again with a focus on the role of profession.
In 2023 Victoria will pause her PhD to commence work on research that examines voice and silence in the ECA supervisory relationship, and in the mentoring relationships ECAs form with academics outside the supervisory relationship.
PROFESSIONAL BIO
Victoria Lister
MBus (Philanthropy & Nonprofit Studies)
MPhil (Marketing)
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Student Representative and Doctoral Workshop Chair
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Consultant
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Non-executive Director
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CEO
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Manager
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Researcher interested in unravelling the hard-to-unravel organisational issues
Victoria is a leader who takes a strategic approach to business, people and research problems. She uses critical thinking skills to shine a light on complex organisational issues in a way that respects the interests of organisations and individuals. Previous research examined dysfunctional leadership in the nonprofit sector; and how to replicate services typically delivered in fixed, traditional settings in atypical, transient environments.