Dangerous Rudeness

Being rude to medical teams impairs their professional performance and causes actual harm to patients. This is evident from a study conducted at the Technion and Bnai Zion Medical Center.

Prof. Arik Riskin of the Technion’s Rappaport Faculty of Medicine and Bnei Zion Medical Center

Prof. Arik Riskin of the Technion’s Rappaport Faculty of Medicine and Bnei Zion Medical Center

Rudeness affects people negatively, even when it comes in small doses. Scorn, contempt and insensitivity not only sadden the individual, but also impair his performance in the aspects of memory, concentration, attention to detail, problem solving and performing various cognitive tasks.

Unfortunately, medical teams are frequently the object of rudeness on the part of patients and their families, as well as their superiors. A new study conducted by Prof. Arik Riskin of the Technion’s Rappaport Faculty of Medicine and Bnei Zion Medical Center examines the implications of these incidents.

The study, which was published recently in the journal “Pediatrics”, reveals that rudeness, even when moderate, dramatically impairs the medical staff’s performance. This impairment, whose severity increases in stressful situations, is evident in the quality of treatment, the level of diagnostics and the technical skills of the staff.

Twenty-four medical teams from four neonatal intensive care units participated in the study. They were invited to a training workshop on the subject of team reflexivity as a tool for improving quality of care. The workshop examined a scenario involving the treatment of a premature infant whose condition suddenly deteriorated due to necrotizing enterocolitis. This scenario required the participants to identify and diagnose the deterioration and administer treatment, including CPR. It was explained to them that an expert from the United States would be watching them remotely (via camera) and would occasionally comment and advise them by phone.

During the simulation, half of the teams received comments from a neutral expert who spoke in general terms about the importance of training and practice using simulations.  The rest of the teams were severely criticized by rude specialist who didn’t even comment on the specific situation and on their performance, and only vigorously criticized the “poor quality of medicine” in Israel. The simulations were recorded on video and presented to judges who evaluated the teams’ performance in accordance with defined criteria: diagnostic capabilities, performance of actions and procedures, and behaviors pertaining to sharing information and asking for help. The judges obviously did not know the identity of the participants (whose faces were blurred) or the nature of the expert that they were exposed to – whether he was polite or rude.

The analysis of the results revealed clear conclusions. “The teams that were exposed to rudeness displayed lower capabilities in all performance metrics,” says Prof. Riskin. “This study demonstrates that rudeness impairs patient safety, all the more so in neonatal intensive care units and intensive care departments, where the slightest error could cause tremendous damage.”

Prof. Riskin conducted the study under the guidance of Prof. Peter Bamberger from the Tel Aviv University School of Management and in collaboration with Prof. Amir Erez from the University Of Florida Warrington College Of Business Administration.

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