"Excuse me:" teaching interns to speak up.

Area of Science:

• Medical Education
• Patient Safety
• Healthcare Communication

Background:

• Interns (junior physicians) often exhibit reluctance to challenge or question senior physicians (attendings or consultants).
• This unwillingness impacts patient safety by hindering error reporting and seeking guidance.
• A training intervention was developed and evaluated at University Hospital Galway.

Purpose of the Study:

• To design, conduct, and evaluate a training program aimed at encouraging interns to speak up to senior physicians.
• To improve communication and assertiveness skills among junior doctors.

Main Methods:

• The training utilized the Crew Resource Management model.
• It incorporated filmed stories of attending physicians reflecting on their own intern experiences with communication challenges.
• 110 interns participated in the training sessions.

Main Results:

• Participant feedback was positive, indicating a favorable reception of the training.
• A significant increase in interns' knowledge regarding the importance of speaking up was observed.
• Evidence suggested a positive shift in attitudes towards speaking up, but no significant change in actual behavior was detected.

Conclusions:

• Sharing personal performance examples is crucial for fostering a strong safety culture.
• Using senior physicians' reflective stories is an effective teaching method for communication and assertiveness skills.
• Sustained behavioral change requires ongoing reinforcement and deliberate practice beyond the initial training.