Mechanisms influencing speaking up behaviours in the presence of witnessed error within the medical hierarchy: A critical realist perspective from regional New South Wales, Australia
Southern Cross University
Doctor of Philosophy (PhD), Southern Cross University
2024
:
https://doi.org/10.25918/thesis.458
70
Medical error (ME) has been identified as the third leading cause of death in the United States of America (USA). Similarly, Australia is estimated to experience between 63,000 and 120,000 preventable deaths annually from ME, with hierarchical communication errors, including failure to speak up, contributing to 23% of those errors. In response, education and professional development for junior medical staff have focused on enhancing their knowledge, skills, and capacity to speak up when witnessing errors. However, this has had little effect. Consequently, the focus of this study was on understanding the causative mechanisms that may influence the senior and junior medical staff’s ability to speak up when witnessing the occurrence of errors.
The aim of this study was to inquire into and understand more fully the mechanisms of influence on speaking up in the presence of witnessed ME. This newly found knowledge will inform the future direction of the continued professional development of the medical workforce to reduce ME and to improve the patient’s experience within the healthcare setting.
This study adopted the theoretical framework of critical realism (CR), and used a case study method employing multiple methods of quantitative and qualitative data collection and analysis. The case study approach delineated the boundaries of the inquiry. This inquiry was undertaken in 2018-2023 in an Australian regional referral hospital and a tertiary referral hospital involving senior medical staff from anaesthetics and emergency medicine and junior medical staff from the same teams.
- Mechanisms influencing speaking up behaviours in the presence of witnessed error within the medical hierarchy: A critical realist perspective from regional New South Wales, Australia
- Rod Peadon
- John Maurice Hurley (Supervisor) - Southern Cross UniversityMarie Hutchinson (Supervisor) - Southern Cross University
- Southern Cross University; Doctor of Philosophy (PhD)
- Doctor of Philosophy (PhD), Southern Cross University
- Southern Cross University
- 372
- 991013278110802368
- © Rod Peadon 2024
- Faculty of Health
- Thesis