Challenging authority and speaking up in the operating room environment: a narrative synthesis
| Autor: | S. Varmani, Cristian Arzola, Archana Malavade, Zeev Friedman, L. Krimus, N. Pattni |
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| Rok vydání: | 2018 |
| Předmět: |
Patient Care Team
Medical education Hierarchy Operating Rooms business.industry Communication Organizational culture PsycINFO Organizational Culture 03 medical and health sciences Patient safety 0302 clinical medicine Anesthesiology and Pain Medicine 030202 anesthesiology Multidisciplinary approach Assertiveness Medicine Humans Narrative Clinical Competence Patient Safety business Curriculum Qualitative research |
| Zdroj: | British journal of anaesthesia. 122(2) |
| ISSN: | 1471-6771 |
| Popis: | Multidisciplinary care teams exist throughout healthcare systems. In the operating room (OR), effective communication between teams is essential, especially during crisis situations where patient safety can be in acute danger. An often-neglected skillset in educational curriculums is challenging authority. This narrative synthesis aims to explore the literature on challenging authority in the OR environment. A systematic search of Medline, EBM reviews and PsycINFO was conducted using terms related to challenging authority, speaking up, communication, patient safety, gradients and hierarchy. The initial search identified 4822 publications, out of which 31 studies were included. The data synthesis of the included studies was grouped into three distinct categories following a meta-aggregative approach: discussion and review articles, observational or qualitative studies, and studies identifying the role of specific barriers or investigating the effect of educational interventions. Themes emerging from expert beliefs, what reality tells us and what we test are consistent. Hierarchy, organisational culture and education are the most frequently observed and tested themes. Simulation research has been successful in eliciting and confirming the role of specific barriers to speaking up. Barriers and enablers are largely modifiable within institutions however, education regarding the importance of speaking up will need to accompany these modifications for any significant changes to occur. |
| Databáze: | OpenAIRE |
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