Perspectives on Bullying, Social Norms, and Reporting Practices: A National Survey of Department Chairs

Introduction: Decades of social norms research has highlighted the tendency for individuals to adjust their behaviors based on their reference (or peer) group. Often, inaccuracies in perceptions (eg, self-other difference [SOD]) can increase or decrease one’s behavior over time. In medical residency, SODs related to perceptions of others’ behaviors predicted the individuals’ who reported bullying behavior, a concerning behavior that is common in medicine. The goal of this study was to expand on previous research examining normative perceptions of bullying and negative acts in medicine. Methods: This study used the 2025 Council of Academic Family Medicine Educational Research Alliance (CERA) survey of family department chairs. This survey was distributed to 197 family medicine department chairs in addition to other staff within the family medicine education department. Measures included perceived risk of experiencing retaliation and questions measuring perceived norms, which were used to calculate SODs. Results: We assessed differences in perceptions (SODs) using t tests. Our analyses suggested that family medicine chairs significantly overestimated the frequency with which peers addressed negative acts but believed that others were less approving of addressing negative acts. We examined predictors of reporting using multiple linear regression. SOD predicted the individual’s tendency to report addressing negative acts. Conclusions: This study expanded on previous research in family medicine and suggested that family medicine department chairs also have inaccurate peer perceptions of attitudes and behaviors related to bullying behavior. Future research might examine the use of social norms interventions as a mechanism to address bullying behavior in family medicine.