Rudeness affects care, accuracy of medical staff

TEL AVIV, Israel, Sept. 8 (UPI) -- Even the most innocent forms of impoliteness between medical personnel, let alone being outright rude to each other, can affect performance and quality of care patients receive, a study conducted at hospitals in Israel found.

Information-sharing and seeking the assistance of coworkers was found, conversely, to mediate the effects of rudeness on performance and maintain higher quality care.

"Relatively benign forms of incivility among medical staff members -- simple rudeness -- have robust implications on medical team collaboration processes and thus on their performance as a team," said Peter Bamberger, a professor in the School of Management at Tel Aviv University, in a press release. "This is important because rudeness is rampant in many medical contexts. Patients and their families may be rude to caregivers, and caregivers may be rude to one another."

Researchers worked with neonatal intensive care units from 24 Israeli hospitals in simulation exercises to test the effects of rudeness on their performance.

The teams were asked to work on a simulated preterm infant with necrotizing enterocolitis, a condition in premature infants where part of the bowel undergoes tissue death, while a foreign expert observed their work. Groups were randomly assigned to either hear negative or neutral comments from the expert while they worked on the patient.

The researchers observed a 12 percent decline in diagnostic and procedural performance scores among the groups who received negative feedback as compared with those hearing neutral comments. Additionally, personnel on the teams who worked together to share information and assist one another mediated some of the adverse effect of the negative comments.

"We hope our findings will shift the focus of research on medical error toward interpersonal interactions and cognition," Bamberger said. "From a practical perspective, we hope it will call attention to the need to shift behavioral norms in medical contexts."

The study is published in Pediatrics.