Jenny W. Rudolph | Harvard Medical School (original) (raw)

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Papers by Jenny W. Rudolph

Advances in Simulation, Jan 21, 2023

Revista clínica española, May 1, 2014

The Journal of Applied Behavioral Science, Aug 1, 2023

Nurturing psychological safety has become a vital antidote to the psychological depletion driving... more Nurturing psychological safety has become a vital antidote to the psychological depletion driving clinicians from healthcare. How to support the clinician's voice, the question at the heart of this study, has never been more important. Here, we explore a hidden aspect of speaking up conversations, how “receivers” experience the dialog. If, when, and how clinicians take in clinically relevant concerns from others is crucial to patient safety. Yet we know little about how different forms of speaking up impact the receiver of the message. We found that receivers of the same message may respond quite differently depending on their professional identity, context, attributions they made, and how the message was phrased. Our findings suggest several actionable practices: (1) Shift the focus of speaking up to training the receiver; (2) frame speaking up as a shared accomplishment; (3) co-create contexts of shared accountability between the speaker and the receiver.

Advances in Simulation

Background Healthcare curricula need summative assessments relevant to and representative of clin... more Background Healthcare curricula need summative assessments relevant to and representative of clinical situations to best select and train learners. Simulation provides multiple benefits with a growing literature base proving its utility for training in a formative context. Advancing to the next step, “the use of simulation for summative assessment” requires rigorous and evidence-based development because any summative assessment is high stakes for participants, trainers, and programs. The first step of this process is to identify the baseline from which we can start. Methods First, using a modified nominal group technique, a task force of 34 panelists defined topics to clarify the why, how, what, when, and who for using simulation-based summative assessment (SBSA). Second, each topic was explored by a group of panelists based on state-of-the-art literature reviews technique with a snowball method to identify further references. Our goal was to identify current knowledge and potentia...

Teaching and Learning in Medicine, Oct 17, 2022

Building on an in-depth study of clinical problem solving in crisis situations, we develop a form... more Building on an in-depth study of clinical problem solving in crisis situations, we develop a formal mathematical model of diagnostic sensemaking that represents the interactions among acting, interpreting cues, and cultivating new diagnoses. Driven by powerful reinforcing dynamics, the interplay among these processes opens and closes windows of opportunity for adaptive sensemaking. There are critical moments before which each activity can remediate weaknesses in the others, and critical moments beyond which the Understanding and improving action-oriented sensemaking during crises in complex, high-stakes settings such as medicine, aviation, nuclear power, or fire-fighting is a crucial aspect of organizing for high reliability. When facing a complex and ambiguous situation where quick action is needed, people have to make sense, to create meaning that

Dynamic modeling as a multidiscipline collaborative journey

Advances in Simulation

Simulation-based learning occurs in multiple contexts, and one teaching style cannot adequately c... more Simulation-based learning occurs in multiple contexts, and one teaching style cannot adequately cover the needs at each learning level. For example, reflective debriefing, often used following a complex simulation case, is not what is needed when learning new skills. When to use which facilitation style is a question that educators often overlook or struggle to determine. SimZones is a framework used to clarify the multiple contexts in simulation. This framework, combined with elements of Debriefing With Good Judgment, can help educators match the appropriate facilitation style with learner needs and learning context. We have distilled the core elements of the “with good judgment” approach to debriefing and applied them to the SimZones framework to guide educators with (1) what type of learning can be expected with each learning context, (2) what behaviors and activities can be expected of the learners in each learning context, (3) what instructional strategies are most effectively ...

Clinical Simulation in Nursing, 2021

BMJ Simulation and Technology Enhanced Learning, 2019

Debriefings should promote reflection and help learners make sense of events. Threats to psycholo... more Debriefings should promote reflection and help learners make sense of events. Threats to psychological safety can undermine reflective learning conversations and may inhibit transfer of key lessons from simulated cases to the general patient care context. Therefore, effective debriefings require high degrees of psychological safety—the perception that it is safe to take interpersonal risks and that one will not be embarrassed, rejected or otherwise punished for speaking their mind, not knowing or asking questions. The role of introductions, learning contracts and prebriefing in establishing psychological safety is well described in the literature. How to maintain psychological safety, while also being able to identify and restore psychological safety during debriefings, is less well understood. This review has several aims. First, we provide a detailed definition of psychological safety and justify its importance for debriefings. Second, we recommend specific strategies debriefers c...

Simulation in healthcare : journal of the Society for Simulation in Healthcare, 2016

Better debriefing practices may enhance the impact of simulation-based education. Emerging litera... more Better debriefing practices may enhance the impact of simulation-based education. Emerging literature suggests that learner-centered debriefing may be effective in helping instructors identify and address learner needs while building learner's engagement and sense of responsibility for learning. This contrasts with instructor-centered approaches to debriefing, where instructors maintain unilateral control over both the process and content of the debriefing, thus limiting input and direction from learners. Although different approaches to debriefing for simulation-based education exist, the simulation literature is largely mute on the topic of learner-centered debriefing. In this article we will (1) compare and contrast learner- versus instructor-centered approaches to teaching; (2) provide a rationale for applying more learner-centered approaches to debriefing; (3) introduce a conceptual framework that highlights the key dimensions of learner- versus instructor-centered debriefi...

Frontiers in Medicine

BackgroundSustaining Basic Life Support (BLS) training during the COVID-19 pandemic bears substan... more BackgroundSustaining Basic Life Support (BLS) training during the COVID-19 pandemic bears substantial challenges. The limited availability of highly qualified instructors and tight economic conditions complicates the delivery of these life-saving trainings. Consequently, innovative and resource-efficient approaches are needed to minimize or eliminate contagion while maintaining high training standards and managing learner anxiety related to infection risk.MethodsIn a non-inferiority trial 346 first-year medical, dentistry, and physiotherapy students underwent BLS training at AIXTRA—Competence Center for Training and Patient Safety at the University Hospital RWTH Aachen. Our objectives were (1) to examine whether peer feedback BLS training supported by tele-instructors matches the learning performance of standard instructor-guided BLS training for laypersons; and (2) to minimize infection risk during BLS training. Therefore, in a parallel group design, we compared arm (1) Standard In...

PLOS ONE, 2021

Introduction Training Basic Life Support saves lives. However, current BLS training approaches ar... more Introduction Training Basic Life Support saves lives. However, current BLS training approaches are time-consuming and costly. Alternative cost-efficient and effective training methods are highly needed. The present study evaluated whether a video-feedback supported peer-guided Basic Life Support training approach achieves similar practical performance as a standard instructor-guided training in laypersons. Methods In a randomized controlled non-inferiority trial, 288 first-year medical students were randomized to two study arms with different Basic Life Support training methods: 1) Standard Instructor Feedback (SIF) or 2) a Peer Video Feedback (PVF). Outcome parameters were objective data for Basic Life Support performance (compression depth and rate) from a resuscitation manikin with recording software as well as overall Basic Life Support performance and subjective confidence. Non-inferiority margins (Δ) for these outcome parameters and sample size calculation were based on previo...

Thisstudyfocusesontheinterpretationsandexperiencesofchangerecipients,thosewhocarryoutorganization... more Thisstudyfocusesontheinterpretationsandexperiencesofchangerecipients,thosewhocarryoutorganizationalinterventionsinitiatedbyothers.Basedonthewaysnursesexpe-rienced a shared governance initiative implemented in their hospital, the authors investi-gated change recipients’sensemaking about organizational change through their ascribedmeanings, emotional responses, and perceptions of its impacts on them. Survey datademonstrated how nurses subjectively assessed their gains and losses from the changeinitiative.Participationintheinitiativeincreasedtheexperienceofgains,asdidmember-shipinaunitwherechangewasimplemented morefully.Textualanalysisofopen-endedresponsestothesurveyindicatedthatgainswerelinkedwithinterpretationsofthechangeinitiative and pleasant feelings and that there was considerable emotional contagionwithin work units. Such effects are particularly likely in employee empowerment initia-tives as experiences are linked to interpretation and mood among change recipients.

Advances in Simulation, Jan 21, 2023

Revista clínica española, May 1, 2014

The Journal of Applied Behavioral Science, Aug 1, 2023

Nurturing psychological safety has become a vital antidote to the psychological depletion driving... more Nurturing psychological safety has become a vital antidote to the psychological depletion driving clinicians from healthcare. How to support the clinician's voice, the question at the heart of this study, has never been more important. Here, we explore a hidden aspect of speaking up conversations, how “receivers” experience the dialog. If, when, and how clinicians take in clinically relevant concerns from others is crucial to patient safety. Yet we know little about how different forms of speaking up impact the receiver of the message. We found that receivers of the same message may respond quite differently depending on their professional identity, context, attributions they made, and how the message was phrased. Our findings suggest several actionable practices: (1) Shift the focus of speaking up to training the receiver; (2) frame speaking up as a shared accomplishment; (3) co-create contexts of shared accountability between the speaker and the receiver.

Advances in Simulation

Background Healthcare curricula need summative assessments relevant to and representative of clin... more Background Healthcare curricula need summative assessments relevant to and representative of clinical situations to best select and train learners. Simulation provides multiple benefits with a growing literature base proving its utility for training in a formative context. Advancing to the next step, “the use of simulation for summative assessment” requires rigorous and evidence-based development because any summative assessment is high stakes for participants, trainers, and programs. The first step of this process is to identify the baseline from which we can start. Methods First, using a modified nominal group technique, a task force of 34 panelists defined topics to clarify the why, how, what, when, and who for using simulation-based summative assessment (SBSA). Second, each topic was explored by a group of panelists based on state-of-the-art literature reviews technique with a snowball method to identify further references. Our goal was to identify current knowledge and potentia...

Teaching and Learning in Medicine, Oct 17, 2022

Building on an in-depth study of clinical problem solving in crisis situations, we develop a form... more Building on an in-depth study of clinical problem solving in crisis situations, we develop a formal mathematical model of diagnostic sensemaking that represents the interactions among acting, interpreting cues, and cultivating new diagnoses. Driven by powerful reinforcing dynamics, the interplay among these processes opens and closes windows of opportunity for adaptive sensemaking. There are critical moments before which each activity can remediate weaknesses in the others, and critical moments beyond which the Understanding and improving action-oriented sensemaking during crises in complex, high-stakes settings such as medicine, aviation, nuclear power, or fire-fighting is a crucial aspect of organizing for high reliability. When facing a complex and ambiguous situation where quick action is needed, people have to make sense, to create meaning that

Dynamic modeling as a multidiscipline collaborative journey

Advances in Simulation

Simulation-based learning occurs in multiple contexts, and one teaching style cannot adequately c... more Simulation-based learning occurs in multiple contexts, and one teaching style cannot adequately cover the needs at each learning level. For example, reflective debriefing, often used following a complex simulation case, is not what is needed when learning new skills. When to use which facilitation style is a question that educators often overlook or struggle to determine. SimZones is a framework used to clarify the multiple contexts in simulation. This framework, combined with elements of Debriefing With Good Judgment, can help educators match the appropriate facilitation style with learner needs and learning context. We have distilled the core elements of the “with good judgment” approach to debriefing and applied them to the SimZones framework to guide educators with (1) what type of learning can be expected with each learning context, (2) what behaviors and activities can be expected of the learners in each learning context, (3) what instructional strategies are most effectively ...

Clinical Simulation in Nursing, 2021

BMJ Simulation and Technology Enhanced Learning, 2019

Debriefings should promote reflection and help learners make sense of events. Threats to psycholo... more Debriefings should promote reflection and help learners make sense of events. Threats to psychological safety can undermine reflective learning conversations and may inhibit transfer of key lessons from simulated cases to the general patient care context. Therefore, effective debriefings require high degrees of psychological safety—the perception that it is safe to take interpersonal risks and that one will not be embarrassed, rejected or otherwise punished for speaking their mind, not knowing or asking questions. The role of introductions, learning contracts and prebriefing in establishing psychological safety is well described in the literature. How to maintain psychological safety, while also being able to identify and restore psychological safety during debriefings, is less well understood. This review has several aims. First, we provide a detailed definition of psychological safety and justify its importance for debriefings. Second, we recommend specific strategies debriefers c...

Simulation in healthcare : journal of the Society for Simulation in Healthcare, 2016

Better debriefing practices may enhance the impact of simulation-based education. Emerging litera... more Better debriefing practices may enhance the impact of simulation-based education. Emerging literature suggests that learner-centered debriefing may be effective in helping instructors identify and address learner needs while building learner's engagement and sense of responsibility for learning. This contrasts with instructor-centered approaches to debriefing, where instructors maintain unilateral control over both the process and content of the debriefing, thus limiting input and direction from learners. Although different approaches to debriefing for simulation-based education exist, the simulation literature is largely mute on the topic of learner-centered debriefing. In this article we will (1) compare and contrast learner- versus instructor-centered approaches to teaching; (2) provide a rationale for applying more learner-centered approaches to debriefing; (3) introduce a conceptual framework that highlights the key dimensions of learner- versus instructor-centered debriefi...

Frontiers in Medicine

BackgroundSustaining Basic Life Support (BLS) training during the COVID-19 pandemic bears substan... more BackgroundSustaining Basic Life Support (BLS) training during the COVID-19 pandemic bears substantial challenges. The limited availability of highly qualified instructors and tight economic conditions complicates the delivery of these life-saving trainings. Consequently, innovative and resource-efficient approaches are needed to minimize or eliminate contagion while maintaining high training standards and managing learner anxiety related to infection risk.MethodsIn a non-inferiority trial 346 first-year medical, dentistry, and physiotherapy students underwent BLS training at AIXTRA—Competence Center for Training and Patient Safety at the University Hospital RWTH Aachen. Our objectives were (1) to examine whether peer feedback BLS training supported by tele-instructors matches the learning performance of standard instructor-guided BLS training for laypersons; and (2) to minimize infection risk during BLS training. Therefore, in a parallel group design, we compared arm (1) Standard In...

PLOS ONE, 2021

Introduction Training Basic Life Support saves lives. However, current BLS training approaches ar... more Introduction Training Basic Life Support saves lives. However, current BLS training approaches are time-consuming and costly. Alternative cost-efficient and effective training methods are highly needed. The present study evaluated whether a video-feedback supported peer-guided Basic Life Support training approach achieves similar practical performance as a standard instructor-guided training in laypersons. Methods In a randomized controlled non-inferiority trial, 288 first-year medical students were randomized to two study arms with different Basic Life Support training methods: 1) Standard Instructor Feedback (SIF) or 2) a Peer Video Feedback (PVF). Outcome parameters were objective data for Basic Life Support performance (compression depth and rate) from a resuscitation manikin with recording software as well as overall Basic Life Support performance and subjective confidence. Non-inferiority margins (Δ) for these outcome parameters and sample size calculation were based on previo...

Thisstudyfocusesontheinterpretationsandexperiencesofchangerecipients,thosewhocarryoutorganization... more Thisstudyfocusesontheinterpretationsandexperiencesofchangerecipients,thosewhocarryoutorganizationalinterventionsinitiatedbyothers.Basedonthewaysnursesexpe-rienced a shared governance initiative implemented in their hospital, the authors investi-gated change recipients’sensemaking about organizational change through their ascribedmeanings, emotional responses, and perceptions of its impacts on them. Survey datademonstrated how nurses subjectively assessed their gains and losses from the changeinitiative.Participationintheinitiativeincreasedtheexperienceofgains,asdidmember-shipinaunitwherechangewasimplemented morefully.Textualanalysisofopen-endedresponsestothesurveyindicatedthatgainswerelinkedwithinterpretationsofthechangeinitiative and pleasant feelings and that there was considerable emotional contagionwithin work units. Such effects are particularly likely in employee empowerment initia-tives as experiences are linked to interpretation and mood among change recipients.