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PSNet: Patient Safety Network
Journal Article

Exposure to incivility hinders clinical performance in a simulated operative crisis.

Katz D, Blasius K, Isaak R, et al. BMJ Qual Saf. 2019;28(9):750-757.

Disruptive and unprofessional behavior in health care can compromise safety culture. Prior research has shown that male physicians and those working in procedural specialties may be more likely to demonstrate unprofessional behavior. Experiencing such incivility may have important implications on the clinical performance of those impacted. In this multicenter, prospective, randomized controlled trial, researchers subjected anesthesiology residents to a simulated operating room emergency in either a normal or a disrespectful environment; blinded evaluators rated their performance. They found that residents exposed to rude environments scored lower on every performance measure, although there was minimal difference in the self-assessment scores between the two groups. The authors suggest that improving the culture in operating room environments is crucial and advocate for focused education on communication in stressful situations during medical training. A past WebM&M commentary discussed an incident involving a communication failure in a pediatric intensive care unit.