JMIR Publications

ABSTRACT

Background:

Since they are key witnesses to the systemic difficulties and social inequities experienced by vulnerable patients, health and social service (HSS) professionals and clinical managers must act as change agents. Using their expertise to achieve greater social justice, change agents employ a wide range of actions that span a continuum from the clinical (microsystem) to the societal (macrosystem) sphere and involve actors inside and outside the HSS system. Typically, however, clinical professionals and managers act in a circumscribed manner, i.e., within the clinical sphere and with patients and colleagues. Among the hypotheses explaining this reduced scope of action is the fear of reprisal. Little is known about the prevalence of this fear and its complex dynamics.

Objective:

The overall aim of this study is to gain a better understanding of the complex dynamic process leading to clinical professionals’ and clinical managers’ fear of reprisal in their change agent actions and senior administrators’ and senior managers’ determination of wrongdoing.

Methods:

A three-part sequential mixed-method design will include: 1) online survey; 2) qualitative grounded theory design; and 3) legal and ethical analysis.

Results:

This ongoing study began in June 2022 and is scheduled for completion by March 2027.

Conclusions:

Instead of acting, fear of reprisal could induce clinical professionals to tolerate situations that run counter to their social justice values. To ensure they use their capacities as an agent serving a population that is or could become vulnerable, it is important to know the prevalence of the fear of reprisal and gain a better understanding of its complex dynamics. Clinical Trial: N/A