Emergency physicians are the most flexible, adaptable, resilient professionals I know. The qualitative comments in this article, while not surprising, are heartbreaking evidence of a remarkable group being pushed well past a breaking point. @CMA_Docsannemergmed.com/article/S0196-… Here are a few examples. The strength of the language used is striking.

"I feel awful about trying to provide good care for my patients in the hallway, and constantly feel like I can’t do a good job anymore and it makes me feel like a terrible doctor." - Emergency Physician

Thrilled to share our latest research on ED teams.

Psychological safety - the ability to take interpersonal risks - is critical to team performance across industries...we have put a spotlight on the concept in emergency medicine.

onlinelibrary.wiley.com/doi/full/10.11…

A thread. Emergency medicine is hard.

To help, we MUST apply the best evidence from teamwork science with the same fervour we apply evidence for interventions for conditions like sepsis/STEMIs.

Our teams and patients deserve it.

It is with mixed emotions I share our research related to the culture of EM during COVID-19.

link.springer.com/article/10.100…

I am simultaneously 1) amazed by the work of ED teams - they are the primary buffer in our system and 2) troubled by tensions and threats posed to our specialty. We harnessed the power of clinicians (ED physicians and nurses) on the ground to understand the impact of COVID-19 on our department.

The department used the data to guide real-time decision making and we used the data to better understand EM culture and the impacts of COVID.

The sim community are leaders in the understanding of psychological safety...but its time we take the theory beyond it's "safe container"...

Expand the way you think about psychological safety by reading our new work in the area!

advancesinsimulation.biomedcentral.com/articles/10.11…

thread... Psychological safety - a shared belief that the team is safe for interpersonal risk taking – has been a focus for sim facilitators. Giants have shown how psych safety can be fostered in the confines of the simulation space.

journals.lww.com/simulationinhe…

@GetCuriousNow

After studying ED teams, I am thrilled to share insights about how they work and some simple hacks to make them even better.

Spoiler alert: psychological safety is what it’s all about - thanks @amyCEdmondson @RoisinODonovan4

#RCEMasc @RCEMevents @SocraticEM

A thread… Emergency medicine is basically just navigating uncertainty together.
Patient after patient.
Shift after shift.

We are quite familiar with good team behaviours that allow us to do so.
We train for things like…

Closing the loop
Recaps
Graded assertiveness
Communication

The acute phase of COVID-19 was a time of cultural magnification and transformation in emergency medicine. It was a time when we could see who we are, recognized what aligned with those values and identified what conflicted with them. #ACEMWS21 @Qemerg A group of clinicians @Qemerg @KingstonHSC engaged in a rapid cycle collaborative ethnography by gathering >50,000 words in field notes and >40 interviews with staff during 12 week period (March-May 2020). Weekly we reported the "pulse" of the ED to department + hospital leaders.

Moments of crisis, like #COVID19, are moments of cultural compression...Moments when values and beliefs of a group are more easily identified and then shaped.

Moments that can tell organizations an awful lot about who we are, what matters most, and who we might become. #EDAC2020 It turns out that psychological safety, the ability for team members to take interpersonal risks, is critical for groups to do their work. In moments of crisis we can clearly see when psychological safety is intact....and...when it is not.

@AmyCEdmondson:
web.mit.edu/curhan/www/doc…