Exposure to incivility does not hinder speaking up: a randomised controlled high-fidelity simulation-based study

Vauk, Stefanie; Seelandt, Julia; Huber, Katja; Grande, Bastian; Kolbe, Michaela

doi:10.1016/j.bja.2022.07.050

Cited by 8 publications

(5 citation statements)

References 78 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…By doing so, receivers were unsure how to respond when the interaction was not confrontational. Vauk, Seelandt [ 55 ] also reported this paradox from the speaker’s perspective. Civil receiver behaviour increased the difficulty to speak up, compared to uncivil behaviour.…”

Section: Discussionmentioning

confidence: 99%

Identification of the barriers and enablers for receiving a speaking up message: a content analysis approach

et al. 2023

View full text Add to dashboard Cite

Background Within healthcare, the barriers and enablers that influence clinicians’ ability to speak up are well researched. However, despite the receiver of the message being identified as a key barrier to a speaker voicing a concern, there have been very few receiver-focused studies. As a result, little is known about the barriers and enablers that influence message reception. Understanding these can help inform speaking up training and ultimately enhance patient safety through more effective clinical communication. Objectives To identify enabling or inhibiting factors that influence the receiver’s reception and response to a speaking up message, and if the identified barriers and enablers are related to speaker or receiver characteristics. Design and methods Twenty-two interdisciplinary simulations were video recorded and transcribed. Simulation participants formed the patient discharge team and were receivers of a speaking up message, delivered by a nurse at the patient’s bedside. How the message was delivered (verbose or abrupt wording), was manipulated and counterbalanced across the simulations. Within the post simulation debriefs, barriers and enablers of being a receiver of a message were explored using content analysis. Setting/participants This study took place in a large Australian tertiary healthcare setting. Participants were qualified clinicians of varying disciplines and specialties. Results A total of 261 barriers and 285 enablers were coded. Results showed that how the message was delivered (differing tone, phases, and manner) influenced what receivers identified as barriers and enablers. Additionally, the receiver’s own cognitive processes, such as making positive attributions of the speaker and attempting to build rapport and collegiality, better enabled message reception and response. Receiver behaviour was negatively impacted by listening to fix, rather than understand, and not knowing in the moment how to manage their own reactions and appropriately frame a response. Conclusion The debriefings identified key barriers and enablers to receiving a speaking up message that differ from those previously identified for senders of the speaking up message. Current speaking up programs are predominately speaker centric. This study identified that both speaker and receiver behaviour influenced message reception. Therefore, training must place equal attention on both the speaker and receiver and be inclusive of experiential conversational rehearsal of both positive and challenging encounters.

show abstract

Section: Discussionmentioning

confidence: 99%

Identification of the barriers and enablers for receiving a speaking up message: a content analysis approach

et al. 2023

View full text Add to dashboard Cite

show abstract

“…TeamSIM includes 12 learning objectives ( Figure 1 ) around recognition and management of knowledge within teams, teaming up, communicating clearly and respectfully, embracing and managing dissent, voice and listening, asking for help and reflexivity ( Larson et al, 1998 ; Christensen et al, 2000 ; Baron, 2005 ; Riskin et al, 2015 ; Schmutz and Eppich, 2017 ; Hamilton et al, 2019 ; Riskin et al, 2019 ; Schwappach et al, 2019 ; Long et al, 2020 ; Jones et al, 2021 ; Kolbe et al, 2021 ; Lemke et al, 2021 ; Rudolph et al, 2021 ; Bamberger and Bamberger, 2022 ; DiPierro et al, 2022 ; Taiyi Yan et al, 2022 ; Vauk et al, 2022 ; Greilich et al, 2023 ; Tannenbaum and Greilich, 2023 ). Additionally, it provides students with the possibility to reflect on the consequences of teamwork for well-being and performance of healthcare professionals as well as for patient care and safety and on implications for their career management.…”

Section: Learning Environment and Formatmentioning

confidence: 99%

“Asking for help is a strength”—how to promote undergraduate medical students’ teamwork through simulation training and interprofessional faculty

Kolbe,

Goldhahn,

Useini

et al. 2023

Front. Psychol.

Self Cite

View full text Add to dashboard Cite

The ability to team up and safely work in any kind of healthcare team is a critical asset and should be taught early on in medical education. Medical students should be given the chance to “walk the talk” of teamwork by training and reflecting in teams. Our goal was to design, implement and evaluate the feasibility of a simulation-based teamwork training (TeamSIM) for undergraduate medical students that puts generic teamwork skills centerstage. We designed TeamSIM to include 12 learning objectives. For this pre-post, mixed-methods feasibility study, third-year medical students, organized in teams of 11–12 students, participated and observed each other in eight simulations of different clinical situation with varying degrees of complexity (e.g., deteriorating patient in ward; trauma; resuscitation). Guided by an interprofessional clinical faculty with simulation-based instructor training, student teams reflected on their shared experience in structured team debriefings. Using published instruments, we measured (a) students’ reactions to TeamSIM and their perceptions of psychological safety via self-report, (b) their ongoing reflections via experience sampling, and (c) their teamwork skills via behavior observation. Ninety four students participated. They reported positive reactions to TeamSIM (M = 5.23, SD = 0.5). Their mean initial reported level of psychological safety was M = 3.8 (SD = 0.4) which rose to M = 4.3 (SD = 0.5) toward the end of the course [T(21) = −2.8, 95% CI −0.78 to-0.12, p = 0.011 (two-tailed)]. We obtained n = 314 headline reflections from the students and n = 95 from the faculty. For the students, the most frequent theme assigned to their headlines involved the concepts taught in the course such as “10 s for 10 min.” For the faculty, the most frequent theme assigned to their headlines were reflections on how their simulation session worked for the students. The faculty rated students’ teamwork skills higher after the last compared to the first debriefing. Undergraduate medical students can learn crucial teamwork skills in simulations supported by an experienced faculty and with a high degree of psychological safety. Both students and faculty appreciate the learning possibilities of simulation. At the same time, this learning can be challenging, intense and overwhelming. It takes a team to teach teamwork.

show abstract

“…Tension, frustration and conflict influence the quality of team interactions. For example, while observing disrespectful behavior may cause team members to speak up with a concern, a general lack of psychological safety or of inclusive language may impede live-saving speaking up ( Edmondson, 2003 ; Raemer et al, 2016 ; Weiss et al, 2018 ; Krenz et al, 2020 ; Vauk et al, 2022 ).…”

Section: Five Different Perspectives For Studying Team Dynamics and T...mentioning

confidence: 99%

“…In this episode, it would be also interesting to examine the speaking up behavior of the participants. One might explore to what extent negative humor influences the speaking up behavior of the ironized group (the nurses) or the whole group and to clarify whether this behavior could be a hindrance or even beneficial for further speaking up ( Parsons et al, 2001 ; Vauk et al, 2022 ).…”

Section: Five Different Perspectives For Studying Team Dynamics and T...mentioning

confidence: 99%

How to enrich team research in healthcare by considering five theoretical perspectives

Seelandt,

Boos,

Kolbe

et al. 2023

Front. Psychol.

Self Cite

View full text Add to dashboard Cite

The aim of this paper is to inspire team research to apply diverse and unconventional perspectives to study team dynamics and performance in healthcare settings. To illustrate that using multiple perspectives can yield valuable insights, we examine a segment of a team interaction during a heart-surgery, using five distinct interdisciplinary perspectives known from small group research: the psychodynamic, functional, conflict-power-status, temporal, and social identity perspectives. We briefly describe each theoretical perspective, discuss its application to study healthcare teams, and present possible research questions for the segment at hand using the respective perspective. We also highlight the benefits and challenges associated with employing these diverse approaches and explore how they can be integrated to analyze team processes in health care. Finally, we offer our own insights and opinions on the integration of these approaches, as well as the types of data required to conduct such analyses. We also point to further research avenues and highlight the benefits associated with employing these diverse approaches. Finally, we offer our own insights and opinions on the integration of these approaches, as well as the types of data required to conduct such analyses.

show abstract

Exposure to incivility does not hinder speaking up: a randomised controlled high-fidelity simulation-based study

Cited by 8 publications

References 78 publications

Identification of the barriers and enablers for receiving a speaking up message: a content analysis approach

Identification of the barriers and enablers for receiving a speaking up message: a content analysis approach

“Asking for help is a strength”—how to promote undergraduate medical students’ teamwork through simulation training and interprofessional faculty

How to enrich team research in healthcare by considering five theoretical perspectives

Contact Info

Product

Resources

About