A new Tel Aviv University study published in Pediatrics shows that rudeness can affect hospital staff's diagnostic and professional performance. The results suggest that even the most benign forms of impoliteness may impede medical personnel's ability to perform under pressure and damage the quality of patient care, according to researchers.

"While the effects themselves were consistent with our theory-based predictions (and hence not surprising), what did surprise us was the magnitude of the effect sizes," Prof. Peter Bamberger, TAU's School of Management - Tel Aviv, told HealthManagement.org. "The size of the effects found was roughly double the size of the effects of other error-related factors examined to date such as physician sleep deprivation."

Bamberger went on to say that relatively benign forms of incivility among medical staff members — simple rudeness — had robust implications on medical team collaboration processes and thus on their performance as a team. "This is important because rudeness is rampant in many medical contexts. Patients and their families may be rude to caregivers, and caregivers may be rude to one another."

For the study, 24 neonatal intensive care units (NICU) teams from hospitals around Israel participated in a simulation exercise involving a premature infant suffering from the common but severe medical complication necrotising enterocolitis (in which bowel tissue disintegrates). Half of the teams performed in the presence of a "rude" expert, who uttered mildly rude statements completely unrelated to the team's performance. The other half completed their tasks under the watchful gaze of a "neutral" commentator.

The simulations were videotaped and presented to three management experts (blinded to team exposure), who evaluated them based on dimensions of help-seeking and information-sharing behaviour among the medical staff, as well as their overall diagnostic and procedural performance. The results showed that teams exposed to rude behaviour shared less information with (and passed less information on to) each other, and demonstrated poorer diagnostic and procedural performance than those not exposed to rudeness.

Bamberger's team is continuing to explore the implications of rudeness in medical situations using other approaches and with an eye to better understanding protective and vulnerability factors.

The current study examined only rudeness stemming from a physician expert from outside the NICU team. "We are conducting other studies examining the effects of rudeness from other sources such as from patient families and even team members. Thus far it appears that the source of rudeness matters little; the effects are the same," Prof. Bamberger said.

Source: American Friends of Tel Aviv University; Interview
Image credit: Pinterest.com


Bamberger PA, Riskin A et al. (2015) The Impact of Rudeness on Medical Team Performance: A Randomized Trial. Pediatrics, August 10, 2015. doi: 10.1542/peds.2015-1385

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healthmanagement, rudeness, quality of care, NICU, impoliteness, medical errors A new Tel Aviv University study published in Pediatrics shows that rudeness can affect hospital staff's diagnostic and professional performance.