Systemic remedies required for radiology trainees to feel comfortable reporting unprofessional behavior
Many radiology trainees feel their workplace culture encourages them to speak up about safety concerns, but fewer have the same impression regarding unprofessional behavior. Experts believe systemic changes are needed to remedy the issue.
That’s according to a new survey of young radiologists from nine hospitals who attended a communication workshop, shared Wednesday in AJR. In total, 84% said their environment promoted asking questions about patient safety, while only 57% felt comfortable reporting unprofessional behavior.
The findings align with prior research, which is notable because inappropriate workplace actions have been linked with poor team performance and patient outcomes, Stephen D. Brown, MD, a radiologist at Boston Children’s Hospital, and colleagues explained.
“Overall, our data add to a burgeoning realization within medicine and radiology that systemic remedies are necessary to establish healthier professional cultures for speaking up about both safety concerns and unprofessional behavior,” the group added in the Feb. 3 study.
The research included 61 radiology residents and fellows from academic training programs in New England who completed questionnaires between 2013 and 2017. Overall, 58 participants finished the surveys.
While the majority of trainees said they felt OK about speaking up, 17% thought it would be difficult to do so if patient safety was on the line and 34% said they would have trouble bringing up unprofessional behavior.
Furthermore, in a hypothetical situation describing a sterile technique error, participants said they were less likely to raise the issue with an attending rad (48% would) compared to a nurse (79%), resident (81%) and intern (84%). Further analysis revealed that non-white respondents were less likely than their white peers to speak up about this specific situation. A “concerning” finding that warrants further discussion the authors noted.
Given these conclusions and those taken from prior research, young radiologists are operating in a clinical environment in which they see themselves as restricted in communicating their concerns.
Leadership must be made aware of how these issues can dramatically harm patients and providers, Brown et al. noted. And aside from this first step, educational interventions such as the Agency for Healthcare Research and Quality's Team Strategies and Tools to Enhance Performance and Patient Safety program may also be of use.
Radiology departments should also consider anonymous online reporting systems and alternate forums for expressing concerns, the authors explained.
“The overall finding that residents are more likely to speak up for safety than for unprofessional behavior has interesting implications for organizational culture in radiology,” the authors concluded. “Given the barriers to speaking up related to authority-based gradients in medical facilities, system-based solutions are needed to promote healthier team environments and ultimately safer care.”
Read the entire study published in the American Journal of Roentgenology here.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.