Trust, communication, theory of mind and the social brain hypothesis

Braithwaite, Jeffrey; Iedema, Rick; Jorm, Christine

doi:10.1108/14777260710778899

Cited by 23 publications

(26 citation statements)

References 100 publications

(154 reference statements)

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“…In these FGDs, we both see evidence of the lack of trust pointed to by Braithwaite et al [14] and the five points highlighted by Walshe and Shortell [15]. RT RNs describe a basic mistrust of physicists, and a situation in which they feel that their professional competence is not trusted by other professionals.…”

Section: Discussionmentioning

confidence: 84%

“…Using evolutionary psychology, Braithwaite et al [14] present conceptual underpinnings of communication breakdown in health care situations, including their potential negative impact on patient care. They summarize the problem saying “when organizational failure looms, trust and communication are compromised” (p 354), arguing that effective communication and trust between professional groups are essential for a well-functioning multidisciplinary team.…”

Section: Discussionmentioning

confidence: 99%

“…They summarize the problem saying “when organizational failure looms, trust and communication are compromised” (p 354), arguing that effective communication and trust between professional groups are essential for a well-functioning multidisciplinary team. Braithwaite et al [14] mean that managers in health care settings rarely succeed in uncovering existing underlying issues and when they do, that poor communication and lack of trust results in the managers often being ignored by staff, which tends to protect their own interests before that of patients. From another perspective, in their analysis of major health care ‘failures’ from six countries, Walshe and Shortell [15] summarize common themes as related to 1) longstanding problems which are 2) well-known but not addressed and 3) which can cause immense harm.…”

Section: Discussionmentioning

confidence: 99%

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‘Information on the fly’: Challenges in professional communication in high technological nursing. A focus group study from a radiotherapy department in Sweden

et al. 2012

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BackgroundRadiotherapy (RT) units are high-tech nursing environments. In Sweden, RT registered nurses (RNs) provide and manage RT in close collaboration with other professional groups, as well as providing nursing care for patients with cancer. Communication demands on these RNs are thus particularly complex. In this study, we aimed to better understand problems, strengths and change needs related to professional communication with and within the RT department, as a basis for developing a situation-specific intervention.MethodsFocus groups discussions (FGDs) were conducted with different professional (RNs, assistant nurses, physicians, engineers and physicists) and user stakeholders. Transcripts of the FGDs were inductively analyzed by a team of researchers, to generate clinically relevant and useful data.ResultsThese findings give insight into RT safety climate and are presented under three major headings: Conceptualization of professional domains; Organization and leadership issues; and Communication forms, strategies and processes. The impact of existing hierarchies, including how they are conceptualized and acted out in practice, was noted throughout these data. Despite other differences, participating professionals agreed about communication problems related to RT, i.e. a lack of systems and processes for information transfer, unclear role differentiation, a sense of mutual disrespect, and ad hoc communication taking place ‘on the fly’. While all professional groups recognized extensive communication problems, none acknowledged the potential negative effects on patient safety or care described in the FGD with patient representatives. While RNs often initially denied the existence of a hierarchy, they placed themselves on a hierarchy in their descriptions, describing their own role as passive, with a sense of powerlessness. Potential safety hazards described in the FGDs include not reporting medical errors and silently ignoring or actively opposing new guidelines and regulations.ConclusionsThere is a risk that RNs who view themselves as disenfranchised within an organization will act with passive resistance to change, rather than as change promoters. As interventions to strengthen teams cannot be stronger than the weakest link, RNs may need support in the transition “from silence to voice” in order to take a position of full professional responsibility in a multi-professional health care team.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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‘Information on the fly’: Challenges in professional communication in high technological nursing. A focus group study from a radiotherapy department in Sweden

et al. 2012

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“…As in other health care settings, work patterns are often professionalised and tribal[6,7]. Staff carry out organisational work and clinical work simultaneously in order to manage and deliver patient care[8] and they relate to most other departments within the hospital to accomplish treatment and placement of patients if they are to be admitted or returned to the community[9-11].…”

Section: Introductionmentioning

confidence: 99%

Understanding communication networks in the emergency department

Creswick

Westbrook

Braithwaite

2009

BMC Health Serv Res

Self Cite

115

103

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BackgroundEmergency departments (EDs) are high pressure health care settings involving complex interactions between staff members in providing and organising patient care. Without good communication and cooperation amongst members of the ED team, quality of care is at risk. This study examined the problem-solving, medication advice-seeking and socialising networks of staff working in an Australian hospital ED.MethodsA social network survey (Response Rate = 94%) was administered to all ED staff (n = 109) including doctors, nurses, allied health professionals, administrative staff and ward assistants. Analysis of the network characteristics was carried out by applying measures of density (the extent participants are concentrated), connectedness (how related they are), isolates (how segregated), degree centrality (who has most connections measured in two ways, in-degree, the number of ties directed to an individual and out-degree, the number of ties directed from an individual), betweenness centrality (who is important or powerful), degree of separation (how many ties lie between people) and reciprocity (how bi-directional are interactions).ResultsIn all three networks, individuals were more closely connected to colleagues from within their respective professional groups. The problem-solving network was the most densely connected network, followed by the medication advice network, and the loosely connected socialising network. ED staff relied on each other for help to solve work-related problems, but some senior doctors, some junior doctors and a senior nurse were important sources of medication advice for their ED colleagues.ConclusionsNetwork analyses provide useful ways to assess social structures in clinical settings by allowing us to understand how ED staff relate within their social and professional structures. This can provide insights of potential benefit to ED staff, their leaders, policymakers and researchers.

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“…24 Braithwaite and colleagues have extended the concept of mindfulness to what they call theory of mind (the capacity to "understand others' behaviours, mental states and intentions, and use this knowledge to advantage") and Machiavellian intelligence (the capacity to "solve social problems, including to befriend others for our own purposes, manipulate social situations, benefit from social alliances, and to deceive and outwit when necessary"). 25 These uniquely human abilities form the basis of positive intangibles in organisations such as trust, team spirit, and reciprocity and negative ones like suspicion and blame.…”

Section: • Agencymentioning

confidence: 99%