Bullying experiences of dental interns working at four dental institutions of a developing country: A cross-sectional study

Background: Bullying is an aggressive and violent behavior marked by repetitive harassment of a weaker victim, which may also occur in the workplace including healthcare settings. Although extensively studied in the west, bullying of workers in the healthcare setting is largely underexplored in the South Asian context.

Objective: The aim of our study was to explore the phenomena of workplace bullying among dental interns in selected dental institutes of Karachi, Pakistan.

Methods: A cross-sectional study was conducted among dental interns working at four dental institutions in Karachi, Pakistan. The Negative acts questionnaire (NAQ-R), a standardized, validated tool was administered to identify bullying experiences among dental interns over the past six months; in addition, demographic information of participants as well as details about their exposure to bullying was collected. A multivariable binary logistic regression was used to identify the correlates of bullying in this population. The study was performed and reported according to the STROBE guidelines. Data was analyzed using STATA 12.0 and SPSS 19.0.

Results: A total of 125 participants were included in our analysis. Bullying prevalence among dental interns based on the operational definition by Mikkelsen stood at 36.8%, while self-labelled bullying was observed in 55 %. Males and participants from private institutions were more likely to self-label themselves as victims. 67% of respondents reported having witnessed bullying. Clinical faculty was identified as the most common perpetrator (23%) followed by colleagues 20% and the dental support staff 17%. Report of bullying among victims was low (14.5%) the most common reason being that "complaining is of no use" (28.8%) and "being afraid of the consequences" (22%).

Conclusions: The results of the study indicate a high prevalence of bullying in the participating dental institutions. Our results indicate a clear need to implement antiviolence regulations, anti-bullying educational programs and advocate further research on interventions to minimize bullying, enhance learning and professional engagement of interns in dental institutions.