Arieh Riskin1, Amir Erez2, Trevor A Foulk2, Amir Kugelman3, Ayala Gover4, Irit Shoris3, Kinneret S Riskin5, Peter A Bamberger6. 1. Recanati School of Business, Faculty of Management, and Neonatology, Bnai Zion Medical Center, Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel; arik.riskin@gmail.com. 2. Warrington College of Business Administration, University of Florida, Gainesville, Florida; and. 3. Neonatology, Bnai Zion Medical Center, Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel; 4. Neonatology, Lady Davis Carmel Medical Center, Haifa, and Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel. 5. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; 6. Recanati School of Business, Faculty of Management, and.
Abstract
BACKGROUND AND OBJECTIVES: Iatrogenesis often results from performance deficiencies among medical team members. Team-targeted rudeness may underlie such performance deficiencies, with individuals exposed to rude behavior being less helpful and cooperative. Our objective was to explore the impact of rudeness on the performance of medical teams. METHODS: Twenty-four NICU teams participated in a training simulation involving a preterm infant whose condition acutely deteriorated due to necrotizing enterocolitis. Participants were informed that a foreign expert on team reflexivity in medicine would observe them. Teams were randomly assigned to either exposure to rudeness (in which the expert's comments included mildly rude statements completely unrelated to the teams' performance) or control (neutral comments). The videotaped simulation sessions were evaluated by 3 independent judges (blinded to team exposure) who used structured questionnaires to assess team performance, information-sharing, and help-seeking. RESULTS: The composite diagnostic and procedural performance scores were lower for members of teams exposed to rudeness than to members of the control teams (2.6 vs 3.2 [P = .005] and 2.8 vs 3.3 [P = .008], respectively). Rudeness alone explained nearly 12% of the variance in diagnostic and procedural performance. A model specifying information-sharing and help-seeking as mediators linking rudeness to team performance explained an even greater portion of the variance in diagnostic and procedural performance (R(2) = 52.3 and 42.7, respectively). CONCLUSIONS: Rudeness had adverse consequences on the diagnostic and procedural performance of the NICU team members. Information-sharing mediated the adverse effect of rudeness on diagnostic performance, and help-seeking mediated the effect of rudeness on procedural performance.
RCT Entities:
BACKGROUND AND OBJECTIVES: Iatrogenesis often results from performance deficiencies among medical team members. Team-targeted rudeness may underlie such performance deficiencies, with individuals exposed to rude behavior being less helpful and cooperative. Our objective was to explore the impact of rudeness on the performance of medical teams. METHODS: Twenty-four NICU teams participated in a training simulation involving a preterm infant whose condition acutely deteriorated due to necrotizing enterocolitis. Participants were informed that a foreign expert on team reflexivity in medicine would observe them. Teams were randomly assigned to either exposure to rudeness (in which the expert's comments included mildly rude statements completely unrelated to the teams' performance) or control (neutral comments). The videotaped simulation sessions were evaluated by 3 independent judges (blinded to team exposure) who used structured questionnaires to assess team performance, information-sharing, and help-seeking. RESULTS: The composite diagnostic and procedural performance scores were lower for members of teams exposed to rudeness than to members of the control teams (2.6 vs 3.2 [P = .005] and 2.8 vs 3.3 [P = .008], respectively). Rudeness alone explained nearly 12% of the variance in diagnostic and procedural performance. A model specifying information-sharing and help-seeking as mediators linking rudeness to team performance explained an even greater portion of the variance in diagnostic and procedural performance (R(2) = 52.3 and 42.7, respectively). CONCLUSIONS: Rudeness had adverse consequences on the diagnostic and procedural performance of the NICU team members. Information-sharing mediated the adverse effect of rudeness on diagnostic performance, and help-seeking mediated the effect of rudeness on procedural performance.
Authors: Traber Davis Giardina; Helen Haskell; Shailaja Menon; Julia Hallisy; Frederick S Southwick; Urmimala Sarkar; Kathryn E Royse; Hardeep Singh Journal: Health Aff (Millwood) Date: 2018-11 Impact factor: 6.301
Authors: William O Cooper; Oscar Guillamondegui; O Joe Hines; C Scott Hultman; Rachel R Kelz; Perry Shen; David A Spain; John F Sweeney; Ilene N Moore; Joseph Hopkins; Ira R Horowitz; Russell M Howerton; J Wayne Meredith; Nathan O Spell; Patricia Sullivan; Henry J Domenico; James W Pichert; Thomas F Catron; Lynn E Webb; Roger R Dmochowski; Jan Karrass; Gerald B Hickson Journal: JAMA Surg Date: 2017-06-01 Impact factor: 14.766
Authors: William O Cooper; David A Spain; Oscar Guillamondegui; Rachel R Kelz; Henry J Domenico; Joseph Hopkins; Patricia Sullivan; Ilene N Moore; James W Pichert; Thomas F Catron; Lynn E Webb; Roger R Dmochowski; Gerald B Hickson Journal: JAMA Surg Date: 2019-09-01 Impact factor: 14.766
Authors: Jennifer K Walter; Theodore E Schall; Aaron G DeWitt; Jennifer Faerber; Heather Griffis; Meghan Galligan; Victoria Miller; Robert M Arnold; Chris Feudtner Journal: J Pain Symptom Manage Date: 2019-04-18 Impact factor: 3.612