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Crossing boundaries…..? or straddling the fence….. ….Uncomfortable journeys in healthcare simulation Dr Victoria Brazil Bond University Gold Coast Health.

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Presentation on theme: "Crossing boundaries…..? or straddling the fence….. ….Uncomfortable journeys in healthcare simulation Dr Victoria Brazil Bond University Gold Coast Health."— Presentation transcript:

1 Crossing boundaries…..? or straddling the fence….. ….Uncomfortable journeys in healthcare simulation Dr Victoria Brazil Bond University Gold Coast Health Service

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5 Tribes in healthcare

6 “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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8 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..”

9 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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11 Can we do more to help?

12 Have our aims and methods in simulation based learning sufficiently recognised the social (tribal) and cultural context of health care?

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14 Uncomfortable journey #1 - Give them a recipe and they’ll be fine

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16 Communication skills training does not necessarily lead to skilled communication

17 Uncomfortable journey #2 – the dominance of exciting stuff

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20 “Simulatoritis….”

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22 Another dark side…….

23 Uncomfortable journey # 3 – negative training

24 QRMSA Rural Preparatory Workshops for JHOs

25 More negative training…..

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27 Uncomfortable journey #4 – the delusion of evaluation!

28 “I feel more confident…..”

29 Uncomfortable journey #5 – failure to connect to patient outcomes or health service priorities

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31 The doctor of the 21 st century?

32 Healthcare simulation – pushing boundaries

33 Some more uncomfortable journeys…..

34 1. Aim small and more boring

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37 2. Get some KPIs

38 “Count something”

39 3. Take a journey to the CEOs office

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41 The doctor of the 21 st century?

42 The doctor of the 21 st 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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44 4. Be a tribal translator

45 …. For our patient sake…..

46 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’

47 @SocraticEM


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