Feedback im Arbeitsleben - eine Selbstwert-Perspektive

Zusammenfassung: Feedback ist unerlässlich und allgegenwärtig. Konstruktives Feedback ist ein wichtiges Führungsinstrument. Gutes Feedback zu geben, ist jedoch alles andere als einfach, und nicht selten fühlen sich Mitarbeitende durch Feedback verletzt und demotiviert. Ein zentraler Aspekt guten Feedbacks bezieht sich auf Aufrechterhaltung, Förderung oder Schädigung des Selbstwerts; der vorliegende Artikel beleuchtet Feedback vor allem unter diesem Aspekt. Diskutiert werden die Bedeutung des Feedbacks für den Selbstwert, Kriterien für optimales Feedback sowie die Schwierigkeiten, optimales Feedback zu geben wie auch Feedback anzunehmen, wobei negatives Feedback im Vordergrund steht. Abschließend wird auf Feedback im Rahmen betrieblicher Leistungsbewertung eingegange

Battery Discharge from Monday to Friday: Background Social Stress at Work is Associated with more Rapid Accumulation of Fatigue

Purpose: This field study investigated the effects of background social stress at work on the weekly course of evening fatigue. Methods: Male employees of a Swiss organisation reported their fatigue after work and at 9 pm in the evening over three weeks. A total of 482 evening fatigue measurements from 34 male participants were subjected to multilevel analysis. Results: Sleep quality in the previous night and fatigue after work predicted evening fatigue. Evening fatigue was not associated with the time spent on daily housework or child care. There was a linear increase in evening fatigue across weekdays and a main effect of workplace social stressors on evening fatigue. Sleep quality during the previous night mediated the link between background social stressors and evening fatigue. Moreover, an interaction between workplace social stressors and working days indicated that fatigue accumulated faster during the working week in those reporting a high level of social stress at work. Conclusion: Social stress at work seems to accelerate the loss of resources over consecutive workdays. The analysis of workplace social stressors and other potential moderators of resource dynamics contributes to our understanding of work-related stress, including the role of background stressors and the temporal dynamics of resource loss

Effects of team leaders' position in cardiopulmonary resuscitation teams on leadership behavior and team performance: A prospective randomized interventional cross-over simulation-based trial.

BACKGROUND Leadership is an important performance factor in resuscitation teams. Medical guidelines for cardiopulmonary resuscitation (CPR) advise team leaders to keep hands off patients. There is little evidence for this recommendation that is based purely on observational data. Accordingly, the aim of this trial was to investigate the effect of leaders' position during CPR on leadership behavior and team performance. METHOD This is a prospective randomized interventional crossover simulation-based single center trial. Teams of 3 to 4 physicians each, representing a rapid response team, were confronted with a simulated cardiac arrest. Team leaders were randomly assigned and assigned team leaders were 1:1 randomized to 2 leadership positions: position at the patient's head; and hands-off position. Data analysis was performed from video-recordings. All utterances during the first 4 minutes of CPR were transcribed and coded based on a modified "Leadership Description Questionnaire." The primary endpoint was the number of leadership statements. Secondary outcomes included CPR related performance markers like hands-on time and chest compression rate, and the behavioral related endpoints Decision Making, Error Detection, and Situational Awareness. RESULTS Data from 40 teams (143 participants) was analyzed. Leaders in hands-off position made more leadership statements (28 ± 8 vs 23 ± 8; P <.01) and contributed more to their team's leadership (59 ± 13% vs 50 ± 17%; P = .01) than leaders in the head position. Leaders' position had no significant effect on their teams' CPR performance, Decision Making, and Error Detection. Increased numbers of leadership statements lead to improved hands-on time ( R = 0.28; 95% confidence interval 0.05-0.48; P = .02). CONCLUSIONS Team leaders in a hands-off position made more leadership statements and contributed more to their teams' leadership during CPR than team leaders actively involved in the head position. However, team leaders' position had no effect on their teams' CPR performance

Social stress in human-machine systems: opportunities and challenges of an experimental research approach

This article presents some deliberations on methodological approaches to researching the effects of work-related social stress on performance, with particular consideration being given to machine-induced social stress. The article proposes a broad methodological approach to examine such effects. A particular focus is placed on performance after-effects (e.g. unscheduled probe tasks), extra-role behaviour, and task management behaviour because of conventional performance measures (i.e. scheduled tasks) often being unimpaired by social stressors. The role of the ‘performance protection mode’ as an important concept is discussed. A distinction is made between three facets of after-effects: performance-related, behavioural, and emotional. Unscheduled probe tasks and voluntary tasks are proposed to measure performance-related and behavioural after-effects. Propositions for specific experimental scenarios are made, allowing for sufficiently realistic simulations of social stress at work. The availability of such lab-based simulations of work environments offers good opportunities for this line of experimental research, which is expected to gain in importance since highly automated systems may modify the impact of human-induced social stress or may even represent a social stressor themselves. Finally, the considerations presented in this article are not only of relevance to the domain of social stress but to experimental stress research in general

Adding insult to injury:Illegitimate stressors and their association with situational well-being, social self-esteem, and desire for revenge

Implying an offense to self, appraising a stressor as indicating a lack of consideration by others should have effects beyond its stressfulness per se. In Stress-as-Offense-to-Self theory (SOS), such stressors are called “illegitimate stressors.” We assessed situations appraised as stressful in two diary studies (N 1 = 117, N 2 = 137). Outcome variables were feelings of resentment in both studies, plus nervousness, anxiety, and sadness in Study 1 and depressive mood, threat to social self-esteem, and desire for revenge in Study 2. Controlling for stressfulness, perceived illegitimacy predicted affective reactions that are outward-directed (feelings of resentment [Studies 1 and 2], threat to social self-esteem and desire for revenge [Study 2]); it also predicted sadness in Study 1 but not depressive mood in Study 2, nor nervousness (Study 1). Thus, not all hypotheses were confirmed but the pattern was as expected, in that results were consistent regarding outcomes typically associated with the attribution of blame. The independent contribution of perceived illegitimacy aligns well with the underlying Stress-as-Offense-to-Self theory. Practical implications refer to efforts to avoid illegitimate stressors, for instance by perspective-taking, by showing appreciation and support, and by supporting such behaviours through keeping stressors in general at a manageable level

StOP? II trial: cluster randomized clinical trial to test the implementation of a toolbox for structured communication in the operating room-study protocol.

BACKGROUND Surgical care, which is performed by intensely interacting multidisciplinary teams of surgeons, anesthetists, and nurses, remains associated with significant morbidity and mortality. Intraoperative communication has been shown to be associated with surgical outcomes, but tools ensuring efficient intraoperative communication are lacking. In a previous study, we developed the StOP?-protocol that fosters structured intraoperative communication. Before the critical phases of the operation, the responsible surgeon initiates and leads one or several StOP?s. During a StOP?, the surgeon informs about the progress of the operation (status), next steps and proximal goals (objectives), and possible problems (problems) and encourages all team members to voice their observations and ask questions (?). In a before-after study performed mainly in visceral surgery, we found effects of the StOP?-protocol on mortality, length of hospital stay, and reoperation. We intend to assess the impact of the StOP?-protocol in a cluster randomized trial, in a wider variety of surgical specialties (i.e., general, visceral, thoracic, vascular surgery, surgical urology, and gynecology). The primary hypothesis is that the consistent use of the StOP?-protocol by the main surgeon reduces patient mortality within 30 days after the operation. The secondary hypothesis is that the consistent use of the StOP?-protocol by the main surgeon reduces unplanned reoperations, length of hospital stay, and unplanned hospital readmissions. METHODS This study is designed as a multicenter, cluster-randomized parallel-group trial. Board-certified surgeons of participating clinical departments will be randomized 1:1 to the StOP? intervention group or to the standard of care (control) group. The intervention group will undergo a training to use the StOP?-protocol and receive regular feedback on their compliance with the protocol. The surgeons in the control group will communicate as usual during their operations. The unit of observation will be operations performed by cluster surgeons. Consecutive patients will be enrolled over 4 months per cluster. A total of 400 surgeons will be recruited, and we expect to collect patient outcome data for 14,000 surgical procedures. DISCUSSION The StOP?-protocol was designed as a tool to structure communication during surgical procedures. Testing its effects on patient outcomes will contribute to implementing evidenced-based interventions to reduce surgical complications. TRIAL REGISTRATION ClinicalTrials.gov NCT05356962. Registered on May 2, 2022

When Illegitimate Tasks Threaten Patient Safety Culture: A Cross-Sectional Survey in a Tertiary Hospital

Objectives: The current study investigates the prevalence of illegitimate tasks in a hospital setting and their association with patient safety culture outcomes, which has not been previously investigated.Methods: We conducted a cross-sectional survey in a tertiary referral hospital. Patient safety culture outcomes were measured using the Hospital Survey on Patient Safety Culture questionnaire; the primary outcome measures were a low safety rating for the respondent’s unit and whether the respondent had completed one or more safety event reports in the last 12 months. Analyses were adjusted for hospital department and staff member characteristics relating to work and health.Results: A total of 2,276 respondents answered the survey (participation rate: 35.0%). Overall, 26.2% of respondents perceived illegitimate tasks to occur frequently, 8.1% reported a low level of safety in their unit, and 60.3% reported having completed one or more safety event reports. In multivariable analyses, perception of a higher frequency of illegitimate tasks was associated with a higher risk of reporting a low safety rating and with a higher chance of having completed event reports.Conclusion: The prevalence of perceived illegitimate tasks was rather high. A programme aiming to reduce illegitimate tasks could provide support for a causal effect of these tasks on safety culture outcomes

When Illegitimate Tasks Threaten Patient Safety Culture: A Cross-Sectional Survey in a Tertiary Hospital.

Objectives: The current study investigates the prevalence of illegitimate tasks in a hospital setting and their association with patient safety culture outcomes, which has not been previously investigated. Methods: We conducted a cross-sectional survey in a tertiary referral hospital. Patient safety culture outcomes were measured using the Hospital Survey on Patient Safety Culture questionnaire; the primary outcome measures were a low safety rating for the respondent's unit and whether the respondent had completed one or more safety event reports in the last 12 months. Analyses were adjusted for hospital department and staff member characteristics relating to work and health. Results: A total of 2,276 respondents answered the survey (participation rate: 35.0%). Overall, 26.2% of respondents perceived illegitimate tasks to occur frequently, 8.1% reported a low level of safety in their unit, and 60.3% reported having completed one or more safety event reports. In multivariable analyses, perception of a higher frequency of illegitimate tasks was associated with a higher risk of reporting a low safety rating and with a higher chance of having completed event reports. Conclusion: The prevalence of perceived illegitimate tasks was rather high. A programme aiming to reduce illegitimate tasks could provide support for a causal effect of these tasks on safety culture outcomes

The workday of hospital surgeons: what they do, what makes them satisfied, and the role of core tasks and administrative tasks; a diary study.

BACKGROUND Many surgeons report passion for their work, but not all tasks are likely to be satisfying. Little is known about how hospital surgeons spend their days, how they like specific tasks, and the role of core tasks (i.e. surgery-related tasks) versus tasks that may keep them from core tasks (e.g., administrative work). This study aimed at a more detailed picture of hospital surgeons' daily work - how much time they spend with different tasks, how they like them, and associations with satisfaction. METHODS Hospital surgeons (N = 105) responded to a general survey, and 81 of these provided up to five daily questionnaires concerning daily activities and their attractiveness, as well as their job satisfaction. The data were analyzed using t-tests, analysis of variance, as well as analysis of covariance and repeated measures analysis of variance for comparing means across tasks. RESULTS Among 14 tasks, surgery-related tasks took 21.2%, patient-related tasks 21.7% of the surgeons' time; 10.4% entailed meetings and communicating about patients, and 18.6% documentation and administration. The remaining time was spent with teaching, research, leadership and management, and not task-related activities (e.g. walking between rooms). Surgery was rated as most (4.25; SD = .66), administration as least attractive (2.63; SD = .78). A higher percentage of administration predicted lower perceived legitimacy; perceived legitimacy of administrative work predicted job satisfaction (r = .47). Residents were least satisfied; there were few gender differences. CONCLUSIONS Surgeons seem to thrive on their core tasks, most notably surgery. By contrast, administrative duties are likely perceived as keeping them from their core medical tasks. Increasing the percentage of medical tasks proper, notably surgery, and reducing administrative duties may contribute to hospital surgeons' job satisfaction

Noise peaks influence communication in the operating room. An observational study

Noise peaks are powerful distractors. This study focuses on the impact of noise peaks on surgical teams' communication during 109 long abdominal surgeries. We related measured noise peaks during 5-min intervals to the amount of observed communication during the same interval. Results show that noise peaks are associated with less case-relevant communication; this effect is moderated by the level of surgical experience; case-relevant communications decrease under high noise peak conditions among junior, but not among senior surgeons. However, case-irrelevant communication did not decrease under high noise level conditions, rather there was a trend to more case-irrelevant communication under high noise peaks. The results support the hypothesis that noise peaks impair communication because they draw on attentional resources rather than impairing understanding of communication. As case-relevant communication is important for surgical performance, exposure to high noise peaks in the OR should be minimised especially for less experienced surgeons. Practitioner Summary: This study investigated whether noise during surgeries influenced the communication within surgical teams. During abdominal surgeries, noise levels were measured and communication was observed. Results showed that high noise peaks reduced the frequency of patient-related communication, but did not reduce patient-irrelevant communication. Noise may negatively affect team coordination in surgeries