Training novice anaesthesiology trainees to speak up for patient safety

Guris, Rodrigo J. Daly; Duarte, Shirley S.; Miller, Christina; Schiavi, Adam; Toy, Serkan

doi:10.1016/j.bja.2019.01.017

Cited by 38 publications

(49 citation statements)

References 27 publications

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“…However, much of the existing literature covers anecdotal experiences with situations that caused compliance and theoretical suppositions about causes and student experience while lacking causative explanation [24][25][26][27][28][29]. There is a small but emerging body of experimental work on these constructs based in psychological theory [30][31][32][33][34]. Recent studies have established the high frequency with which medical students and residents, nurses, and staff physicians witness issues with professionalism and patient safety, and experience challenges to speaking up [35][36][37][38] yet currently lacking are frequencies of how often health professional students from a range of professions experience negative compliance integrated with psychological theory and relevant constructs [29].…”

Section: Introductionmentioning

confidence: 99%

A multi-method exploratory study of health professional students’ experiences with compliance behaviours

2020

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Background Research in healthcare, including students as participants, has begun to document experiences with negative compliance, specifically conformity and obedience. There is a growing body of experimental and survey literature, however, currently lacking is a direct measure of the frequency at which health professional students have negative experiences with conformity and obedience integrated with psychological factors, the outcomes of negative compliance, and students’ perceptions. Methods To develop empirical knowledge about the frequency of negative compliance and student perceptions during health professional education a multi-methods survey approach was used. The survey was administered to health professional students across ten disciplines at four institutions. Results The results indicated students regularly experience obedience and conformity and are influenced by impression management and displacement of responsibility. Moral distress was identified as a consistent negative outcome. Student self-reported experiences aligned with the empirical findings. Conclusions The findings of the present study demonstrate the pervasiveness of experiences with negative compliance during health professional’s education along with some attendant psychological factors. The findings have educational and practical implications, as well as pointing to the need for further integration of social and cognitive psychology in explaining compliance in healthcare. The results are likely generalizable to a population level however replication is encouraged to better understand the true frequency of negative compliance at a health professional population level.

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Section: Introductionmentioning

confidence: 99%

A multi-method exploratory study of health professional students’ experiences with compliance behaviours

2020

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“…We believe that repetitive practice of SBC leads to increased situational awareness and SE that empowers participants to activate various levels of support, depending on the specific situation, and communicate with confidence and clarity in a crisis. 69 Future studies are warranted to examine the relationship of task-specific SE to task performance and cognitive burden. Future studies using this program as a platform will involve comparison of specific simulation methods and effect on task performance as well as the relationship between SE and concrete measures of competency such as examination scores and faculty evaluations.…”

Section: Discussionmentioning

confidence: 99%

Anesthesia Simulation Boot Camp—a Decade of Experience Enhancing Self-efficacy in First-year Residents

2020

JEPM

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“…The influence of individual differences on speaking up has been examined to varying degrees with indeterminant findings related to personality traits, confidence, self-efficacy, and profession (Barzallo Salazar et al, 2014;Daly Guris et al, 2019;Kuo, et al, 2020;Oner, et al, 2018;Roussin et al, 2018;Sydor et al, 2013). In general, sex differences are not influential in obedience to authority (Blass, 1999); though contexts may exist where sex differences are important (Pattni et al, 2017;Roussin et al, 2018).…”

Section: Individual Characteristicsmentioning

confidence: 99%

A behavioural study of obedience in health professional students

Violato

Witschen

Violato

et al. 2021

Adv in Health Sci Educ

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Interprofessional Education and Collaborative Practice (IPECP) is a field of study suggested to improve team functioning and patient safety. However, even interprofessional teams are susceptible to group pressures which may inhibit speaking up (positive deviance). Obedience is one group pressure that can inhibit positive deviance leading to negative patient outcomes. To examine the influence of obedience to authority in an interprofessional setting, an experimental simulated clinical scenario was conducted with Respiratory Therapy (RT) (n = 40) and Advanced Care Paramedic (ACP) (n = 20) students. In an airway management scenario, it was necessary for students to challenge an authority, a senior anesthesiologist, to prevent patient harm. In a 2 × 2 design cognitive load and an interventional writing task designed to increase positive deviance were tested. The effect of individual characteristics, including Moral Foundations, and displacement of responsibility were also examined. There was a significant effect for profession and cognitive load: RT students demonstrated lower levels of positive deviance in the low cognitive load scenario than students in other conditions. The writing task did not have a significant effect on RT or ACP students’ behaviour. The influence of Moral Foundations differed from expectations, In Group Loyalty was selected as a negative predictor of positive deviance while Respect for Authority was not. Displacement of responsibility was influential for some participants thought not for all. Other individual variables were identified for further investigation. Observational analysis of the simulation videos was conducted to obtain further insight into student behaviour in a compliance scenario. Individual differences, including experience, should be considered when providing education and training for positive deviance. Simulation provides an ideal setting to use compliance scenarios to train for positive deviance and for experimentation to study interprofessional team behaviour.

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Training novice anaesthesiology trainees to speak up for patient safety

Cited by 38 publications

References 27 publications

A multi-method exploratory study of health professional students’ experiences with compliance behaviours

A multi-method exploratory study of health professional students’ experiences with compliance behaviours

Anesthesia Simulation Boot Camp—a Decade of Experience Enhancing Self-efficacy in First-year Residents

A behavioural study of obedience in health professional students

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