Human factors He highlighted another high-profile airline
crash - Airblue Flight 202 - which resulted in 152 casualties in 2010. The flight recording revealed that the pilot in control of the aircraft at the time, Captain Chaudhry, had deviated from the established procedures for an approach. However, the co-pilot, First Officer Ahmed, was largely unresponsive and passive about them – even when the aircraft was put in a dangerously close position to terrain. The recording showed that he had only voiced his concerns on limited occasions. His muted behaviour could be explained by
his treatment by the Captain, during the initial segment of the flight. During Flight 202’s initial climb, Captain Chaudhry decided to test First Officer Ahmed’s knowledge. Unsatisfied with the result of the test, Captain Chaudhry berated his co-pilot and humiliated him for around an hour. “What happens when there is a steep authority gradient is people go down and stay down – they don’t speak up about anything safety critical,” said Mark. He outlined some examples of uncivil
behaviours, which included: l Giving dirty looks or eyerolling. l Insulting and yelling at others. l Having one’s credibility questioned in front of others.
l Belittling or condescending comments or ‘jokes’.
l Overruling decisions without giving a reason. l Disrupting meetings. l Being berated for action in which no one took part.
l Ignoring/excluding people. l Talking behind people’s backs/gossiping. l Sighs/muttering. l Dismissive gestures.
l Not giving credit where it is due. l Voice intonation. l Social exclusion.
Mark further cited the work of Christine Porath and Christine Pearson who wrote about the ‘Price of Incivility’.2
Through a poll of 800
managers and employees in 17 industries, they discovered the effects of incivility on staff behaviour and attitudes: l 48% intentionally decreased their work effort. l 47% intentionally decreased the time spent at work.
l 38% intentionally decreased the quality of their work.
l 80% lost work time worrying about the incident.
l 63% lost work time avoiding the offender. l 66% said that their performance declined. l 78% said that their commitment to the organisation declined.
l 12% said that they left their job because of the uncivil treatment.
l 25% admitted to taking their frustration out on customers.
However, if the organisation gets it right, civility can have the following impact: l 59% are more likely to share information. l 72% are more likely to share advice. l 57% are more likely to seek information. l 71% are more likely to work harder.
Mark also highlighted the work of Chris Turner, a consultant in emergency medicine at University Hospitals of Coventry and Warwickshire, who founded the Civility Saves Lives campaign, to raise awareness of the power of civility in healthcare.3
Chris Turner gave a powerful Ted talk titled: ‘When rudeness in teams turns deadly’. You can view the full video at: https://www.tedxexeter. com/speakers/chris-turner-2/ In this 15-minute talk, Chris Turner described a safety incident involving a serious medication error, in which a large overdose of a toxic drug was administered to a child. The nurses had asked the consultant on two occasions for advice and guidance on the dosage for paediatrics and were told: “For god’s sake, can’t you see I’m busy!” and to go and look it up. An investigation placed the blame entirely on the nurses’ competency and recommended further training. But the investigation missed the point, he asserted, and therefore the team missed the opportunity to ‘do better’. In his investigations of safety incidents, Chris
Turner said that he found that “process has its place, but something is more important - and that’s people”. He explained how “rudeness can become deadly”. In 2015, Riskin and Erez produced a seminal paper on ‘The Impact of Rudeness on Medical Team Performance’.4
Twenty-four NICU teams
participated in a training simulation involving a preterm infant whose condition acutely deteriorated due to necrotising enterocolitis. Participants were informed that an expert on team reflexivity in medicine would observe them. Teams were randomly assigned to either exposure to rudeness (in which the expert’s comments included mildly rude statements) or neutral comments (the control group). The videotaped simulation sessions were evaluated for team performance, information-sharing, and help-seeking. In his TedTalk, Chris Turner explained that the
researchers found that one factor was responsible for 40-60% of the variance in performance between the teams – and that factor was rudeness. He commented that for competent teams, the single most important factor in determining the outcome of that team, is how the members of that team treat each other. After the video clip concluded, Mark went
on to describe Chris Turner’s concept of ‘the pool of information’. He explained that the pool analogy highlights the value of inclusivity, diversity and civility in teams. Having a variety of culturally diverse team members from different backgrounds contributing to the flow of information into the pool is beneficial, he pointed out, but if one person experiences rudeness, they will ‘turn off their tap’. Those ‘around the pool’ may then decide to turn off their tap too – through a ‘bystander effect’. The take home message is that when someone is rude, it reduces the person’s bandwidth; their ability to effectively juggle
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