crossing boundaries…..? or straddling the fence…
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Dr Victoria Brazil Bond University Gold Coast Health Service. Crossing boundaries…..? or straddling the fence…. ….Uncomfortable journeys in healthcare simulation. Tribes in healthcare. - PowerPoint PPT PresentationTRANSCRIPT
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Crossing boundaries…..? or straddling the fence…..
….Uncomfortable journeys in healthcare simulation
Dr Victoria BrazilBond UniversityGold Coast Health Service
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Tribes in healthcare
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“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
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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..”
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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..”
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Can we do more to help?
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Have our aims and methods in simulation based learning sufficiently
recognised the social (tribal) and cultural context of health care?
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Uncomfortable journey #1
- Give them a recipe and they’ll be fine
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Communication skills training does not necessarily lead to skilled communication
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Uncomfortable journey #2
– the dominance of exciting stuff
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“Simulatoritis….”
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Another dark side…….
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Uncomfortable journey # 3
– negative training
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QRMSA Rural Preparatory Workshops for JHOs
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More negative training…..
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Uncomfortable journey #4
– the delusion of evaluation!
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“I feel more confident…..”
00.5
11.5
22.5
33.5
44.5
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Uncomfortable journey #5
– failure to connect to patient outcomes or health service priorities
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The doctor of the 21st century?
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Healthcare simulation – pushing boundaries
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Some more uncomfortable journeys…..
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1. Aim small and more boring
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1. Aim small and more boring
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1. Aim small and more boring
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2. Get some KPIs
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2. Get some KPIs
“Count something”
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3. Take a journey to the CEOs office
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3. Take a journey to the CEOs office
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The doctor of the 21st century?
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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
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4. Be a tribal translator
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4. Be a tribal translator
…. For our patient sake…..
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SummaryTribes 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’