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Pediatrics. 2017 Feb;139(2). pii: e20162305. doi: 10.1542/peds.2016-2305. Epub 2017 Jan 10.

Rudeness and Medical Team Performance.

Author information

1
Coller School of Management, and arik.riskin@gmail.com.
2
Neonatology, Bnai Zion Medical Center, Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
3
Warrington College of Business Administration, University of Florida, Gainesville, Florida; and.
4
Sackler School of Medicine, University of Tel Aviv, Tel Aviv, Israel.
5
Israel Center for Medical Simulation, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
6
Coller School of Management, and.

Abstract

OBJECTIVES:

Rudeness is routinely experienced by medical teams. We sought to explore the impact of rudeness on medical teams' performance and test interventions that might mitigate its negative consequences.

METHODS:

Thirty-nine NICU teams participated in a training workshop including simulations of acute care of term and preterm newborns. In each workshop, 2 teams were randomly assigned to either an exposure to rudeness (in which the comments of the patient's mother included rude statements completely unrelated to the teams' performance) or control (neutral comments) condition, and 2 additional teams were assigned to rudeness with either a preventative (cognitive bias modification [CBM]) or therapeutic (narrative) intervention. Simulation sessions were evaluated by 2 independent judges, blind to team exposure, who used structured questionnaires to assess team performance.

RESULTS:

Rudeness had adverse consequences not only on diagnostic and intervention parameters (mean therapeutic score 3.81 ± 0.36 vs 4.31 ± 0.35 in controls, P < .01), but also on team processes (such as information and workload sharing, helping and communication) central to patient care (mean teamwork score 4.04 ± 0.34 vs 4.43 ± 0.37, P < .05). CBM mitigated most of these adverse effects of rudeness, but the postexposure narrative intervention had no significant effect.

CONCLUSIONS:

Rudeness has robust, deleterious effects on the performance of medical teams. Moreover, exposure to rudeness debilitated the very collaborative mechanisms recognized as essential for patient care and safety. Interventions focusing on teaching medical professionals to implicitly avoid cognitive distraction such as CBM may offer a means to mitigate the adverse consequences of behaviors that, unfortunately, cannot be prevented.

Comment in

PMID:
28073958
DOI:
10.1542/peds.2016-2305
[Indexed for MEDLINE]
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