Civility and Professional Behaviours Workshop for Midwives
The Brief:
This case study will outline the implementation and impact of a simulation-based workshop designed to furnish midwifery participants with the skills to explore how people feel in the moment, demonstrate and identify kindness and compassion, recognise and challenge incivility and create respectful relationships, all of which contribute to a safe working environment.
The Problem:
In a highly pressurised NHS system, behaviours of incivility and disrespect can have a snowball effect, mounting and spreading within teams. This has implications on staff wellbeing and engagement, which in turn, impacts on patient care. Disrespectful interactions can result in a reduction in teamwork and quality of work which can cause an increase in error rates. Often disrespectful interactions create a sense of unease and reluctance to speak up when needed. The “Ockenden Report” (2022) and “Reading the Signals” (2022) report on East Kent maternity and neonatal services further demonstrate and outline a number of these issues.
The Requirement:
The workshop was required to provide participants with the skills to identify incivility and use effective communication to challenge it, therefore promoting civility and kindness within the team. The foundations of the workshop were required to be based, in part, on “The Ockenden Report” (2022) and “Reading the Signals” (2022).
The Outcome:
The simulation-based workshop consisted of forum theatre, fishbowl simulation and observed simulation delivered by actors. Participants were given the opportunity to interact with actor role players who were taking on the roles of patients and colleagues in a variety of scenarios set on a labour ward, neonatal unit and in an antenatal clinic. Scenario one focussed on demonstrating kindness and support and creating a sense of psychological safety when working with student midwives and junior team members. Scenario two explored the impact conversations can have on colleagues and patients or relatives that may be within earshot. Scenario three includes challenging a senior colleague’s inappropriate behaviour assertively. Scenario four demonstrates kindness and empathy in the context of a patient who has experienced a previous traumatic delivery. The simulated scenarios were then followed by structured debriefs facilitated by experts, drawing out identified themes and learning objectives and providing the opportunity for feedback and reflection upon participants’ previous experiences and perspectives. At the end of the workshop, participants were invited to share their pledges of what they personally would like to do differently in the future.
Tangible Results:
Analysis of the evaluations demonstrate a clear shift in knowledge from before the workshop to after the workshop. This is shown in figure 1; before the workshop 25% of the participants expressed either limited, neutral, or no knowledge in at least one topic area whereas following the workshop, 98% of the participants expressed excellent or good knowledge in all topic areas.
The evaluation also encouraged the participants to note any qualitative comments they had on the workshop (figure 3).
Conclusion:
The simulation-based workshop, “Civility and Professional Behaviours” resulted in a significant increase in participants’ awareness and knowledge of the importance of civility within clinical practice. Many have engaged in personal reflection, honed their communication skills and developed their confidence when communicating with senior colleagues, in addition to recognising the importance of escalating concerns. These positive outcomes yield substantial benefits, impacting not only individual development but patient safety, experience and organisational effectiveness.
References:
Ockenden, D. (2022, March 30) Ockenden Report Findings, Conclusions and Essential Actions From the Independent Review of Maternity Services at The Shrewsbury and Telford Hospital NHS Trust https://assets.publishing.service.gov.uk/media/62433358d3bf7f32b317e8e5/Final-Ockenden-Report-print-ready.pdf