Using a novel simulation approach to address incivility and enhance patient safety in the neonatal intensive care unit
Barah Hassan, Robert Tinnion, Claire Granger, Katie D'Eath, Luqman Randeree, Anna Jackson, Jenna GilloneObjective:
To evaluate the impact of a novel simulation-based design on incivility as part of human factors training.
Design:
A multidisciplinary educational innovation and quality improvement project using high-fidelity simulation and structured debriefing.
Setting:
Conducted as part of an existing simulation programme within a tertiary neonatal unit and aligned delivery suite within a UK NHS Foundation Trust.
Participants:
Staff members totalling 57, of whom 17 were active simulation participants and 40 were observers involved in debriefing. Interventions: Three distinct scenarios (handover, ward round, emergency theatre) incorporating standardised and scripted incivility events delivered by trained confederates.
Outcomes:
Post-simulation surveys using 5-point Likert scales (scenario realism, learning objectives, debriefing effectiveness) and a self-reported question on preparedness to address incivility.
Results:
Respondents ( n =57) answered that scenarios showed high realism (mean score 4.4/5); 92% rated debriefing effectiveness as 5/5. Post-session, 93% of respondents reported feeling ‘somewhat’ or ‘definitely’ more prepared to recognise and address incivility. Qualitative themes identified passive acceptance and a perceived professional hierarchy as primary barriers to challenging behaviour.
Conclusion:
Relabelling incivility as a patient safety threat through simulation triggers a reflective response in staff.
Implications for Practice:
This model is applicable to acute care units seeking to improve communication and provide training on this important human factors topic.