Faculty, Medical
Conditions
Keywords
Education, Curriculum, Anesthesiology, Operating Rooms
Brief summary
Importance Team members speaking-up by raising concerns about inappropriate or unsafe actions of others within the team can have direct, immediate, and preventive effect on adverse outcomes. However, little is known about the hurdles and enablers of this behavior in healthcare, especially within the operating room setting. Objective 1\. Determine if an educational workshop would improve speaking-up behaviors of practicing anesthesiologists when presented with realistically-simulated clinical situations. 2.Describe speaking-up behaviors addressed to a surgeon, a nurse, and a colleague. 3. Identify the self-reported hurdles and enablers for speaking-up in those situations encountered. Design Randomized controlled experiment of an educational workshop intervention on communication behaviors in a simulated case. Qualitative analysis of debriefing conversations following the simulated case. Setting Established academic simulation center Participants Seventy-one practicing anesthesiologists from four academic medical centers and one community hospital Intervention Fifty minute educational workshop on speaking-up that included rationale, conversational techniques, a rubric for speaking-up, and role-play.
Detailed description
Main Outcomes and Measures 1\. Observed communication in a simulated case that included a surgeon falling asleep during surgery, inappropriate activation of a speakerphone by a nurse, and an incorrect treatment order by a colleague in response to a venous air embolism. 2. Transcribed conversation during a structured debriefing, analyzed for hurdles and enablers.
Interventions
OTHEREducational Workshop on Speaking-Up
Educational workshop including lecture, discussion, role-play Concepts include: 2-challenge rule, pairing advocacy and inquiry
OTHERUnrelated Education (CPR)
Unrelated Education (CPR workshop) including: lecture, discussion Topics covered: Cardiac Life Support algorithms, CPR, Medications
Sponsors
Anesthesia Patient Safety Foundation
Massachusetts General Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Attending Anesthesiologist
Exclusion criteria
* Prior exposure to test case
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Speaking-Up Behavior | Immediate | Subjects were assessed by trained raters as to whether they spoke-up when safety related errors were made during a realistic simulation case. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Speaking-up Behaviors | Immediate | Anesthesiologist subject's behavior in speaking-up to a surgeon, nurse, and colleague during a realistic simulation case were assessed descriptively. |
| Self-reported hurdles and enablers of speaking-up | 1 hour | A qualitative analysis of stated hurdles or enablers for speaking-up or not was conducted from video recordings of a post-case structured debriefing. |
Countries
United States
Outcome results
None listed