Disruptive behavior in the workplace: Challenges for gastroenterology fellows

Area of Science:

• Medical Education
• Gastroenterology Training
• Professionalism in Medicine

Background:

• Difficult interpersonal situations are common in healthcare.
• Effective management of disruptive behavior is crucial for patient care and team dynamics.
• Gastroenterology fellows require specific skills to navigate these challenges.

Purpose of the Study:

• To evaluate first-year gastroenterology fellows' competence in managing difficult interpersonal situations.
• To utilize objective structured clinical examinations (OSCE) as an assessment tool.
• To identify areas for improvement in fellows' professional conduct and conflict resolution skills.

Main Methods:

• Two OSCE scenarios were developed: "distracted care team" and "frazzled intern."
• Standardized patients and actors simulated disruptive behavior and challenging clinical scenarios.
• Fellows' performance was assessed using checklists and self-assessment surveys.

Main Results:

• In the "distracted care team" scenario, only one-third of fellows effectively refocused attention, and half maintained professionalism amid conflict.
• Fellows scored lowest in interprofessionalism, indicating challenges in handling workplace conflict.
• In the "frazzled intern" scenario, most fellows established rapport, but communication of plans and guidance skills were inconsistent.

Conclusions:

• Gastroenterology fellows require targeted training to effectively address disruptive behavior.
• Objective structured clinical examinations (OSCE) are valuable tools for assessing and developing these essential skills.
• Implementing OSCEs can foster a culture that encourages open discussion and professional development.