Skip to main content

"Excuse Me:" Teaching Interns to Speak Up

Buy Article:

$12.00 plus tax (Refund Policy)

Abstract:

Background: A consistent finding in health care is that interns (junior physicians) are unwilling to "speak up" to attendings or consultants (senior physicians), which involves the related behaviors of challenging or questioning the actions of attendings, seeking guidance about one's own performance, and reporting one's errors. Training designed to encourage interns to speak up was designed, conducted, and evaluated at University Hospital Galway, an academic teaching hospital affiliated with the National University of Ireland, Galway, in January 2012–March 2012 and November 2012–January 2013.

Method: Training, which was based on the Crew Resource Management model, was constructed around filmed stories of attending physicians describing situations in which, when they were interns, their communication and assertiveness skills were challenged, and their reflections on what they could have done better.

Results: A total of 110 interns attended the training. The feedback from participants was positive. There was a significant increase in knowledge as a result of the training, and some evidence to support a shift in attitudes in the desirable direction relating to the need to speak up to seniors. No effect of the training was found on behavior.

Conclusions: The willingness to share examples of poor performance is an important part of building a good safety culture. Listening to the stories of attendings describing and reflecting on a situation in which they struggled is a powerful teaching method for training interns in the communication and assertiveness skills that are critical to their job. However, a sustained change in attitudes and behavior to speaking up will require a reinforcement of learning with deliberate practice to develop the skills introduced through the training program.

Document Type: Research Article

Publication date: 2013-09-01

More about this publication?
  • The Joint Commission Journal on Quality and Patient Safety will be published by Elsevier beginning in 2017! For readers who receive access to the journal through their institutions, the journal can now be found on ScienceDirect (http://www.sciencedirect.com/science/journal/15537250). For librarians looking to subscribe to the journal for their institutions please contact your Elsevier Account Manager or visit www.myelsevier.com for more information. All other readers, please visit http://www.jointcommissionjournal.com/ to subscribe to the journal or to claim your access for an existing subscription.
  • Editorial Board
  • Information for Authors
  • Subscribe to this Title
  • Information for Advertisers
  • Reprints and Permissions
  • Index
  • Ingenta Connect is not responsible for the content or availability of external websites
  • Access Key
  • Free ContentFree content
  • Partial Free ContentPartial Free content
  • New ContentNew content
  • Open Access ContentOpen access content
  • Partial Open Access ContentPartial Open access content
  • Subscribed ContentSubscribed content
  • Partial Subscribed ContentPartial Subscribed content
  • Free Trial ContentFree trial content
Cookie Policy
X
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more