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Helping without harming by Jenny Rudolph


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You've been resuscitating the patient for hours and finally caught up with volume. You come back on your next shift only to find your colleague has been diuresing them all day.

What the heck were they thinking!?! This normal response to colleagues when they miss the mark clinically gets in the way of improving their—and our—performance. It’s natural to judge, to assume our own method is best, and condemn “that idiot” for their wrong-headed approach. In fact, a host of research says we are programed to respond with exasperation and negative judgment. Expert-level critical care performance however, requires feedback, coaching, and collaboration. We have to harness the energy behind our righteous indignation into a spicy mixture of feedback for and curiosity about our colleagues. Paradoxically, our vexation, when channeled into a combination of good judgment plus curiosity can boost quality and collaboration in critical care. Using research on feedback, debriefing and interprofessional communication, this talk illuminates four steps for collaborating to improve performance: 1) Note performance gap, 2) Reset one’s reaction to the gap; 3) Explore the thinking behind the performance; 4) Tailor a win-win solution to their thinking and yours.

Published in: Health & Medicine
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Helping without harming by Jenny Rudolph

  1. 1. Helping without Harming: Transforming Critical Care Conflicts Through Curiousity Jenny Rudolph, PhD Center for Medical Simulation Massachusetts General Hospital Harvard Medical School Social Media in Academic Critical Care Berlin, 2017
  2. 2. The battle of the amygdala versus pre-frontal cortex under stress in difficult conversations In high stakes conversations... Dysfunctional reactions are overdetermined! How?  Fundamental attribution error  Intent-impact mismatch  System 1—unawareness, speed, automaticity ,(over) confidence The way out? The neuropsychology of curiosity and positive regard From automatic to deliberate processing under threat  Why care?? a pay-off for clinical management, interprofessional collaboration and patient care Rudolph and Repenning, 2002 Academy of Management Review
  3. 3. Virtuous or viscous cycles in conversation?? A reinforcing loop propels us to be over-confident, even fixate on our beliefs about others Rudolph, Morrison, Carroll 2009 Academy of Management Review Cues Available Plausibility of Leading DiagnosisUpdating Time Needed to Update Plausibility from New Cues Weight on Cues Effect of Plausibilityon Cue Interpretation R Self-Fulfilling Interpretation Loop
  4. 4. Judgment is normal Curiosity is normal
  5. 5. What The F**K???
  6. 6.  Bayfield versus Hayes
  7. 7. Certainty This is the most defining and dangerous characteristic of certainty: it is toxic to a shift in a perspective. When we are caught up in our own convictions, other people’s stories –– which is to say other people— cease to exist. Kathryn Schultz, Being Wrong, Adventures at the Margin of Error
  8. 8. What’s missing?
  9. 9. What’s love got to do with it?!
  10. 10. Why?
  11. 11. @s_eller WTF To... WTF (What’s the frame?) (Susan Eller)
  12. 12. What The F**K???
  13. 13. WTF? ? What’s the Frame?
  14. 14. What’s the frame?