Disruptive behavior in the workplace: Challenges for gastroenterology fellows
AIM To assess first-year gastroenterology fellows’ ability to address difficult interpersonal situations in the workplace using objective structured clinical examinations(OSCE).METHODS Two OSCEs('distracted care team' and 'frazzled intern') were created to assess...
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Published in | World journal of gastroenterology : WJG Vol. 23; no. 18; pp. 3315 - 3321 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Baishideng Publishing Group Inc
14.05.2017
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Subjects | |
Online Access | Get full text |
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Summary: | AIM To assess first-year gastroenterology fellows’ ability to address difficult interpersonal situations in the workplace using objective structured clinical examinations(OSCE).METHODS Two OSCEs('distracted care team' and 'frazzled intern') were created to assess response to disruptive behavior. In case 1, a fellow used a colonoscopy simulator while interacting with a standardized patient(SP), nurse, and attending physician all played by actors. The nurse and attending were instructed to display specific disruptive behavior and disregard thefellow unless requested to stop the disruptive behavior and focus on the patient and procedure. In case 2, the fellow was to calm an intern managing a patient with massive gastrointestinal bleeding. The objective in both scenarios was to assess the fellows’ ability to perform their duties while managing the disruptive behavior displayed by the actor. The SPs used checklists to rate fellows’ performances. The fellows completed a selfassessment survey.RESULTS Twelve fellows from four gastrointestinal fellowship training programs participated in the OSCE. In the 'distracted care team' case, one-third of the fellows interrupted the conflict and refocused attention to the patient. Half of the fellows were able to display professionalism despite the heated discussion nearby. Fellows scored lowest in the interprofessionalism portion of post-OSCE surveys, measuring their ability to handle the conflict. In the 'frazzled intern' case, 68% of fellows were able to establish a calm and professional relationship with the SP. Despite this success, only half of the fellows were successfully communicate a plan to the SP and only a third scored 'well done' in a domain that focused on allowing the intern to think through the case with the fellow’s guidance.CONCLUSION Fellows must receive training on how to approach disruptive behavior. OSCEs are a tool that can assess fellow skills and set a culture for open discussion. |
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Bibliography: | Nalinee Srisarajivakul;Catherine Lucero;Xiao-Jing Wang;Michael Poles;Colleen Gillespie;Sondra Zabar;Elizabeth Weinshel;Lisa Malter;Division of Gastroenterology, VA New York Harbor Healthcare System;Division of General Internal Medicine, NYU School of Medicine;Division of Gastroenterology and Hepatology, Weill Cornell Medical College;Department of Internal Medicine, Emory University School of Medicine ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23 Author contributions: Srisarajivakul N, Lucero C, Weinshel E and Malter L contributed to analysis and interpretation of the data; Srisarajivakul N, Lucero C, Poles M, Weinshel E and Malter L contributed to drafting of the manuscript; Lucero C, Wang XJ, Weinshel E and Malter L contributed to study concept and design; Lucero C, Wang XJ, Gillespie C, Weinshel E and Malter L contributed to data acquisition; Wang XJ, Poles M, Gillespie C and Zabar S contributed in critical revision of the manuscript for important intellectual content; Malter L supervised the study. Correspondence to: Elizabeth Weinshel, MD, Professor, Division of Gastroenterology, VA New York Harbor Healthcare System, 423 East 23rd Street, New York, NY 10010, United States. elizabeth.weinshel@nyumc.org Telephone: +1-917-6347394 |
ISSN: | 1007-9327 2219-2840 |
DOI: | 10.3748/wjg.v23.i18.3315 |