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Approaching difficult conversations with curiosity helps everyone learn

What if the conversation you really don’t want to have could make you a better colleague, educator, mentor, or health care provider?

Difficult conversations

That’s the premise of “Conversations in Just Culture,” an interdisciplinary session for attendees of the 7th annual Quality and Safety Symposium at University of Iowa Hospitals & Clinics. This session will be on Thursday, Nov. 21.

“Just Culture changes the assumptions underlying difficult conversations,” says Paul Leonard, MD, one of the facilitators for Thursday’s session. “For example, if someone cuts us off when we’re driving, we often assume the other driver is a jerk. But in a just culture, we approach that behavior from a sense of curiosity — wanting to find out why instead of making assumptions.”

During Thursday’s session, representatives of the hospital’s simulation community will present examples of making assumptions versus exhibiting curiosity, and then participants will have an opportunity to practice with facilitators observing and providing guidance.

Clark Obr, MD, director of the Simulation Center in the Department of Anesthesia, and his son, Brooks Obr, MD, MME, assistant residency program director in the Department of Emergency Medicine, will be two of the facilitators Thursday. Father and son both use simulation in their respective roles and are champions of the practice throughout health care.

“Simulation represents a unique way to teach and learn,” Brooks Obr says. “It provides a flexible, safe environment for experiential learning.”

Clark Obr notes that assumptions can play an outsized role in simulation, as well. “I was teaching a resident in the Simulation Center, and she broke down crying,” Obr recalls. “I didn’t understand why she was upset, but by approaching it from a curiosity standpoint, I discovered that she was viewing the session as a test instead of as a safe place to make mistakes and learn. Once we identified that faulty assumption together, we were able to move on and make the simulation a valuable experience for both of us.”

The annual Quality and Safety Symposium is one of the most interdisciplinary events at University of Iowa Hospitals & Clinics, drawing facilitators and participants from virtually every corner of the institution. The group facilitating the “Conversations in Just Culture” session also reflects that holistic feel, comprising individuals from seven clinical disciplines (Advanced Practice Nursing, Anesthesia, Emergency Medicine, Nursing, Obstetrics and Gynecology, Pediatrics, and Surgery) and three non-clinical disciplines (Engineering, Quality Improvement, and Simulation).

“It’s been a wonderful experience to work with this team of trainers,” Brooks Obr says. “The unique views and experiences that everybody brings to the table have made me a better simulator, educator, and healthcare provider. I firmly believe that one of the great strengths of this team is the diverse set of specialties and experiences that it is formed from.”

Leonard hopes Thursday’s participants will take away at least the beginnings of a new perspective on difficult conversations.

“We can’t give them all the practice our team has had, but we do hope they experience the feeling of how applying curiosity can flip the script on an argument,” he says. “It’s not about being nice or being mean. It’s about having the respect for the other person to question your assumptions.”


Monday, November 18, 2019