Simulcast Journal Club is a monthly series that aims to encourage simulation educators to explore and learn from publications on Healthcare Simulation Education. Each month we publish a case and link a paper with associated questions for discussion. Inspired by the ALiEM MEdIC series, we moderate and summarise the discussion at the end of the month, including exploring the opinions of experts from the field.
The journal club relies heavily on your participation and comments and while it can be confronting to post your opinions on an article online, we hope we can generate a sense of “online psychological safety” enough to empower you to post! Your thoughts are highly valued and appreciated, however in depth or whatever your level of experience. We look forward to hearing from you.
Title : “Pointing Fingers”
The Article :
Additional Reading & Podcast for those interested in a deep dive :
The Case :
“I think it’s important that we highlight this is a debrief, not a chance to point fingers.”.
Nimali paused and took a deep breath. Debriefing a traumatic event (particularly the sudden murder of a reviled colleague) had exposed frames that were more tribal than she’d anticipated. Within this small group of people the frames were legion. She glanced nervously across at Nitin, grateful that his calming, loving presence was within reach across the circle from her.
“What else are we supposed to do, Nimali?” Jess snapped angrily. “We know full well that one of us murdered him. And let’s face it, some people here have a clear motive.”. Jess’ usually unflappable emergency nurse façade dropped for a moment. “Everyone in PICU hated Snythe, especially you Brad. Didn’t you once tell him that his primary source of hydration was the carbonated tears of bullied interns?”.
Brad choked on his coffee and coughed frantically as he formed a counterpoint. “I did hate Snythe.” He admitted. “But truth be told in a high stakes environment like children’s ICU, there’s lots of strong personalities I don’t always warm up to. We have to be hard. We see too many children die to be cuddly. He was a cynic, but so am I in some ways… I respected him. He was a good intensivist, he was just a pretty nasty person. I’d trust Snythe if my child was on inotropes, no questions.”.
Catherine gave a wry half smile, “I’m glad you could see the good in him, his behaviour in ED left him few friends. His brand of hierarchical bullshit didn’t go down well when we called him for help.”.
Jacob frowned. “I guess I didn’t know Snythe as much as an Intensivist, I knew him as an educator. And in the last 12 months he’d grown into a much more open person. The same vicious sarcasm he had on the ward would sometimes be disarmingly funny when we were teaching new grads together. He’d even applied to be director of education a few weeks ago… He asked me for a reference.”.
Jess glanced at Brad again. “Didn’t you apply for that job?”.
A heavy silence hung for a few seconds in the room when suddenly the lights blacked out and the room descended into darkness. Nimali jumped as her phone began to ring frantically with missed call notifications.
Her iPhone lit up in the darkness :
Last month in journal club, we explored teamwork behaviours through an ethnographic lens. This month we want to extend that conversation by exploring other in depth theories regarding barriers to effective team formation. In this month’s open access article, Bochatay et al explore the way we filter the messages we receive from other people by their hierarchical position and social group. For those among you who are deep divers, we’ve also attached a podcast and additional editorial with similar themes.
We look forward to the discussion!