Active bystander training beyond the pilot: evaluation across learner groups, cohort sizes, and educational settings

Introduction Active bystander training (ABT) has been cited as a solution to bullying and harassment at the place of work. We have previously shown that a pilot study of ABT sessions in a single institution significantly improved medical students’ knowledge of how to recognise disrespectful behaviour. We evaluated whether a previously developed Active Bystander Training programme could be adapted and delivered in a second medical school, to larger cohorts and to a professionally diverse audience, while retaining measurable immediate educational outcomes. Methods Learning and teaching materials were updated and uploaded onto an online platform for easy access. Four facilitators from the pilot study (School A) met with colleagues from a large medical school (School B) to plan and adapt ABT sessions to deliver a condensed, small-group training and to larger groups (final-year medical students). ABT was also delivered to a large, mixed group of learners at a national conference. Results In a pilot small group of fourth-year medical students (14 students; 11 paired evaluations) from School B, the mean increase in post-intervention scores was 11.6 (95% CI 7.8–15.3, p < 0.001). The median increase in post-intervention scores for the larger cohort final-year medical students (377 students; 64 paired evaluation) was 8.5 (approximate 95% CI 8–8.5, p < 0.001). Both showed increases in questionnaire scores, although no formal between-group comparison was undertaken. The mean increase in post-intervention scores for learners attending a national conference (121 delegates; 8 paired evaluations) was 4.75 (95% CI 1.2–8.3, p = 0.016). Conclusion A previously evaluated ABT programme was successfully adapted for delivery in a second medical school, to a whole-year cohort and to a professionally diverse national audience. These findings support the feasibility of wider delivery while identifying the need for longitudinal evaluation of behavioural and implementation outcomes.