crossing boundaries…..? or straddling the fence….. ….uncomfortable journeys in healthcare...
TRANSCRIPT
Crossing boundaries…..? or straddling the fence…..
….Uncomfortable journeys in healthcare simulation
Dr Victoria BrazilBond UniversityGold Coast Health Service
Tribes in healthcare
“Speaking up against a power gradient, or challenging a member of a different ‘tribe’ requires courage, and so poor decisions may go unchecked”
Jennifer Weller. Shedding new light on tribalism in healthcare. Medical Education 2012
As a DEM specialist [DEMC4] describes, this facilitates the emergence of ingroup solidarity:
“…and if we constantly feel in a state of siege of us against everyone we’re trying to refer to,…….I think everyone like to have a little team allegiance.. And having a common enemy is a really great bonding experience for a team..”
As a DEM specialist [DEMC4] describes, this facilitates the emergence of ingroup solidarity:
“…and if we constantly feel in a state of siege of us against everyone we’re trying to refer to,…….I think everyone like to have a little team allegiance.. And having a common enemy is a really great bonding experience for a team..”
Can we do more to help?
Have our aims and methods in simulation based learning sufficiently
recognised the social (tribal) and cultural context of health care?
Uncomfortable journey #1
- Give them a recipe and they’ll be fine
Communication skills training does not necessarily lead to skilled communication
Uncomfortable journey #2
– the dominance of exciting stuff
“Simulatoritis….”
Another dark side…….
Uncomfortable journey # 3
– negative training
QRMSA Rural Preparatory Workshops for JHOs
More negative training…..
Uncomfortable journey #4
– the delusion of evaluation!
“I feel more confident…..”
00.5
11.5
22.5
33.5
44.5
Uncomfortable journey #5
– failure to connect to patient outcomes or health service priorities
The doctor of the 21st century?
Healthcare simulation – pushing boundaries
Some more uncomfortable journeys…..
1. Aim small and more boring
1. Aim small and more boring
1. Aim small and more boring
2. Get some KPIs
2. Get some KPIs
“Count something”
3. Take a journey to the CEOs office
3. Take a journey to the CEOs office
The doctor of the 21st century?
The doctor of the 21st century
• Lead in complexity, and be expert in systems and team based care
• Train other providers to do many tasks we currently do
• Be stewards of healthcare resources• Improve care through practice audit and
skilled analysis of patient outcome data• ….? And more
4. Be a tribal translator
4. Be a tribal translator
…. For our patient sake…..
Summary
Tribes and culture in healthcare are critical ingredients for effective simulation
Take uncomfortable journeys…..
Aim small and more boring
‘Count something’
Get to the CEOs office
Be ‘tribal translators’
