Lifelong Learning Programme

This project has been funded with support from the European Commission.
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Training for Paediatricians and Paediatric Students

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This training package is addressed to students and medical practitioners in paediatrics on how to autonomously learn, develop and consolidate their soft skills for improving the quality of paediatric services.

Communicating with Peers

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4.3 – Teamwork Attitudes in Paediatrics: to Offer Advice, Provide Instructions, Feedback and Information among Peers
Effective team is a guarantee for patient safety and high quality of care in high-risk situation, for that reason concerns about communication, coordination and cooperation among the team member constitute an ethical, legal and deontological duty. The lack of communication and teamwork conflicts can drive to adverse event and be a source of bad practice, with the consequences to harm patients. Teamwork includes cognitive-behavioural dimension, i.e. a common representation of care tasks and the ability to communicate about the execution of these tasks, and interpersonal teamwork, referred to the quality of collaboration between team members (Welp et al.;2016). Recent studies about the role of teamwork attitudes reported significant improvement of patient care and clinical outcomes as a consequence of team-training intervention focused on soft-skills improvement Among the aspects of the teamwork significant to improve professionals performances there are: 1) Quality of collaboration: mutual respect and trust among the team members; 2) shared clinical strategies: define common goals and share a common view about the team role, structures and tasks; 3) coordination: implement an adaptive model considering the integration of the new members joined in the team, shift between implicit and explicit form of coordination, improve information processes; 4) communication: implement communication practices such as briefing and debriefing, work on common frame of reference in order to have a shared conceptual framework and language; 5) leadership: share decision–making and recognize staff effort to improve teamwork, explicit the leadership behaviour in critical situations (Weaver et al; 2015). The teamwork communication improvement can be assured through the election of the adequate style and the implementation of good practice in communication processes. Communication style in health care are characterized by 4 basic patterns: 1) aggressive, the process is oriented to engage a personal attack and intimidate the other through the imposition of communicators’ personal view. Aggressive communicators they feels inadequate, without empathy and belief the only way to allow their goals is power and control (Sherman, 2015); 2) assertive communication is a middle point between aggressive and passive communication style, assign responsibility to the communicators and constitute a direct way to communicate. Assertive communicators have self-esteem, supporting and avoid conflicts and usually offer benefits for communicators and receiver; 3) passive communication consist in not express directly wishes or thoughts and put the communicator’s need at the end of the priorities list. Communicator is convinced that is thoughts are not important and his/her opinion is not relevant to decision-making; 4) passive aggressive communication integrate passive and aggressive patterns of communication, the communicator exposes his/her anger procrastinating, avoiding, or being intentionally inefficient (Hennessy, 2015). Among the good practices to improve communication in health care there are briefing and debriefing, the first one can be formal, i.e. the medical history written in a structured way, or informal, a short discussion about clinical aims and therapeutic strategies to allow them. Debriefing is generally subsequent to the briefing and consists in the analysis and understanding of a clinical circumstance to learn about the context and change attitudes. Debriefing consents to identify and synthetize changes for the future and improve the clinical performance, is a critical process, without judgment, promoting self-analysis (Rudolf, 2007).
Practical Applications
Case Scenario 5 – Communication style: give assertively advice, feedback, instructions and information This scenario represents a resident and a tutor in a conversation about how to overcome teamwork conflict in clinical setting. Tutor attitude represent a model of good practice to improve teamwork performances through a definition of common aims, advice about how to improve the resident performance, feedback about previous mistakes and future strategies to avoid them.
Skills in the video: the video is an example of strategy to improve the teamwork performances and offer a good example of all the requirements offered by literature, such as quality collaboration, sharing clinical knowledge, coordination, communication, leadership.
The video is in English and subtitles in English are available
Case scenario 6 – Communication style: passive communication This scenario is an example of passive communication, and shows how this style can be excusive and potentially dangerous for the teamwork. The scenario is a discussion between a doctor and a nurse about how to lead with a patient-problem. Nurse is an example of passive style and aggressive doctor communication style contributes to allocate the nurse in this role. The combination of passive and aggressive style is negative for the patient care.
Skills in the video: the video offer an example of communication style to be avoided and define the virtue of assertive communication proposing negative models.
The video is in English and subtitles in English are available
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This project has been funded with support from the European Commission. This web site reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information contained therein.