Understanding observed receiver strategies in the healthcare speaking up context

Abstract

Our study aimed to examine the communication behaviours of receivers responding to a speaking up message from a nurse. Specifically, what behaviours receivers of the speaking up message used to understand and address their concerns, and whether observed receiver communication behaviours differed between the health disciplines (receiver groups). Deductive content analysis, through the application of Communication Accommodation Theory, was used to analyse observed receiver behaviour. We used simulation to directly observe speaking up interactions. Data collection occurred between May and November 2019 within a large metropolitan health organization. Twenty-two simulations were conducted and analysed, involving participants ( Nurses/midwives frequently utilized task-based questioning, which inhibited their ability to promptly recognize the speaker’s concern. In contrast, medical officers more readily provided reassurance and support to the speaker and sought clearer understanding of the situation through using more open-ended questioning techniques. Simulation was an effective means to study receiver behaviour. Results demonstrated the receiver’s clinical discipline influenced not only what behaviour strategies were deployed, but the effectiveness of the strategies in accurately interpreting and effectively resolving the raised concern. This study has important implications for clinical practice and how receivers of a speaking up message are trained. As different disciplines approached the same conversation in very different ways, understanding these differences is key to increasing the efficacy of healthcare speaking up training.