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Deliberate practices of speaking up and responding skills: the Speak-PREP e-learning module for healthcare professionals
  1. Megan M Gray1,
  2. Elizabeth Rosenman2,
  3. Jennifer A Best2,
  4. Barbara Menzel3,
  5. Gabrielle Berger2,
  6. Ross Ehrmantraut4,
  7. Pete Napolitano5,
  8. Rachel Umoren1,
  9. Sara Kim6
  1. 1Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
  2. 2Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
  3. 3B.S., M.C. Dispute Resolution, Dispute Resolution Center of Snohomish, Everett, Washington, USA
  4. 4Department of Medicine, WISH, University of Washington School of Medicine, Seattle, Washington, USA
  5. 5Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA
  6. 6Department of Surgery, University of Washington, Seattle, Washington, USA
  1. Correspondence to Dr Megan M Gray, Pediatrics, University of Washington School of Medicine, Seattle, WA 98105, USA; graym1{at}uw.edu

Abstract

Purpose Speaking up and responding to others’ concerns promotes patient safety. We describe health professionals’ utilisation of these important skills.

Method We developed an interactive e-learning module, Speak-PREP, to train healthcare professionals in speaking up and responding strategies. Participants completed interactive video-based exercises that engaged them with entering speaking up and responding statements, augmenting strategies from a list of prompting phrases and responding to a pushback. We report strategy utilisation.

Results A total of 101 health professionals completed Speak-PREP training. Most frequently used speaking up strategies were: brainstorming to explore solutions (50%), showing consideration of others (45%) and encouraging others’ opinions through invitations (43%). Responding strategies included reflecting the concern expressed by colleagues, discussing next steps and expressing gratitude (70%, 67% and 50%, respectively). When prompted, participants augmented their statements with reframing concerns, asking questions to deepen understanding, using how or what to start questions and expressing curiosity (p<0.00001, p=0.003, p=0.0002 and p<0.0001, respectively). Pushbacks lead to increased use of reflecting the concern and decreasing consideration, curiosity, empathy, expressing gratitude and encouraging others’ opinions (p<0.05 for all).

Conclusions The Speak-PREP module targeted deliberate practice in speaking up and responding skills. Future work should examine the application of these strategies in the clinical environment.

  • patient safety
  • communication
  • behaviour
  • learning
  • strategy

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Footnotes

  • Contributors MMG, JAB, PN, RU, SK and RE contributed to initial study design, educational materials review and writing. MMG oversaw data collection and analysis and took a lead in drafting. ER and GB assisted with data interpretation and writing. BM assisted with content expertise and educational materials writing.

  • Funding This work was funded by the University of Washington Patient Safety Innovations Program (award number PSIP4).

  • Disclaimer The funders had no role in the study outside of grant review and funding approval.

  • Competing interests None declared.

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

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