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Infodemic: what physician leaders learned during the COVID-19 outbreak: a qualitative study
  1. Kum-Ying Tham1,
  2. Qinghui Lu2,
  3. Winnie Teo3
  1. 1 Emergency Department, Tan Tock Seng Hospital, Singapore
  2. 2 Surgery Centre, Raffles Hospital, Singapore
  3. 3 Group Education, National Healthcare Group, Singapore
  1. Correspondence to Dr Winnie Teo, Group Education, National Healthcare Group, Singapore, Singapore; winnie_ll_teo{at}


Background Effective crisis leadership is dependent on the key tasks of sense-making, decision-making, meaning-making, learning and crisis termination. While instant messaging and social media provided abundant and powerful sources of information during the COVID-19 pandemic, the infodemic—an overabundance of information, some of which is inaccurate—has also complicated the tasks of crisis leadership.

Methods A qualitative study was undertaken, using semistructured interviews with physician leaders in the hospital dealing with majority of Singapore’s COVID-19 cases. Participants were asked about how they used digital communication tools in their leadership roles before and during the outbreak, and their reflections on the use of these tools. Interviews were audio-recorded, transcribed, coded and subjected to inductive thematic analysis.

Results Twenty-four physician leaders described the adaptations to crisis leadership tasks using digital communication tools. While these tools were useful for rapid collective sense-making, meaning-making was the most challenging because information was posted by others who were faster, competed with their ability to create nuanced versions of a coherent narrative for stakeholders. Leaders also shared the need to balance their relationship with their smartphone and use digital tools to communicate purpose and meaning to and with their staff when face-to-face meetings are not possible.

Conclusions The COVID-19 infodemic has disrupted the key tasks of crisis leadership. For each task leaders on the front line can adopt measures to harness the power of and minimise the risk of damage by instant messaging. Infodemic management must be explicitly included in crisis management training for leaders.

  • clinical leadership
  • communication
  • management

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  • Contributors All three authors conceived and designed the study. QL and WT collected the data. All authors conducted the data analysis. K-YT drafted the initial version of the manuscript. All authors contributed to interpretation of the data and critically revised the manuscript, had full access to the data in the study and can take responsibility for the integrity of the data and accuracy of the data analysis. K-YT is the guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the National Healthcare Group Domain Specific Review Board (Approval no. 2020_00175). All participants have given informed consent before taking part in this study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. No additional data or information is available.

  • Author note A summary of the results of this study will be sent to the research participants.

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