Honest communication and social asymmetries inside a hospital: Pitfalls for clinicians.
Honest communication and social asymmetries inside a hospital: Pitfalls for clinicians.
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医院内的诚实沟通和社会不对称：临床医生的陷阱。
DOI：
10.1002/jhm.12827
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发表时间：
2022
影响因子：
2.6
通讯作者：
Umberin Najeeb
中科院分区：
文献类型：
--
作者：
D. Redelmeier;E. Etchells;Umberin Najeeb
场景。今天，医学部主任参加了你们的巡视，以努力更好地了解医务人员。你感到骄傲和紧张交织在一起。首席执行官以深思熟虑的一对一的方式单独称呼你，但一再发错你的名字。你想知道如何最好地纠正这个错误。医疗护理需要大量的教育、经验、技能、耐力和敏锐。这些专业需求造成了临床医生之间基于资历、声誉或其他区别的人际权力差异。例如，普通的首席住院医师比普通初级实习生更有权势。这种不对称在医院很常见(表1)。反过来，权力差异可能会在举报申诉方面造成障碍，因为脆弱的个人可能会因为害怕报复而不愿投诉。在极端情况下，医疗领域令人震惊的权力滥用表明，专业培训并不能消除权力差异中的虐待。1在更有规律的日常基础上，在权力差异中不愿直言不讳可能会助长沉默文化，并推迟有效解决方案的启动。2在社会等级制度中，不愿直言不讳的现象可以追溯到古希腊(帕罗西亚)，通常被表示为向权力说真话的挑战。诺姆·乔姆斯基提供了一个特别的
Scenario. The chief of medicine joins you on rounds today in an effort to become more acquainted with medical staff. You feel a mixture of pride and nervousness. The chief addresses you individually in a thoughtful one‐on‐one manner but repeatedly mispronounces your name. You are wondering how best to correct this error.Medical care requires substantial education, experience, skill, stamina, and acumen. These professional demands create interpersonal power differentials between clinicians based on seniority, reputation, or other distinctions. The average chief medical resident, for example, is more powerful than the average junior medical intern. Such asymmetries are common in hospitals (Table 1). In turn, the power differentials may contribute to barriers in reporting grievances because vulnerable individuals can be reluctant to complain due to fears of retaliation. At the extreme, appalling abuses of power in medicine indicate that professional training does not eradicate mistreatment from power differentials. 1 On a more regular daily basis, the reluctance to speak up within a power differential can contribute to a culture of silence and delay the initiation of effective solutions. 2 The reluctance to speak up inside a social hierarchy dates to ancient Greece (parrhesia) and is commonly denoted as the challenge of speaking‐truth‐to‐power. Noam Chomsky offered a particularly
影响因子：
7.6
作者：
E. Pronin;J. Kruger;Kenneth Savtisky;L. Ross
通讯作者：
E. Pronin;J. Kruger;Kenneth Savtisky;L. Ross
影响因子：
13.6
作者：
Macy, Michael;Deri, Sebastian;Tong, Natalie
通讯作者：
Tong, Natalie