Rudeness and team performance: Adverse effects via member social value orientation and coordinative team processes.

A growing body of research shows that rudeness negatively affects individual functioning and performance. Considerably less is known about how rudeness affects team processes and outcomes. In a series of five studies aimed at extending theories of the social-cognitive implications of rudeness to the team level, we show that rudeness is detrimental to team functioning. Using an experimental design, Study 1 shows that teams encountering rudeness perform worse than other teams. Study 2, a medical simulation study, explains this effect by showing that medical teams exposed to rudeness are less likely than other teams to share information and workload and, in turn, execute a variety of medical procedures less well. Studies 3a and 3b highlight the mediating role played by social value orientation (SVO), demonstrating that rudeness elicits these effects by diminishing members' SVO (i.e., making team members less prosocial and more pro-self). In turn, Study 4 shows that rudeness-diminished SVO explains reduced information sharing in teams. Finally, Study 5, a laboratory study, tests a full serial mediation model, demonstrating that rudeness decreases team members' SVO, which in turn reduces team information sharing and, as a result, encumbers team performance. Overall, these findings show that rudeness can have severe implications for team functioning and may even have life-threatening consequences. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Trapped by a first hypothesis: How rudeness leads to anchoring.

In this article we explore the effect of encounters with rudeness on the tendency to engage in anchoring, one of the most robust and widespread cognitive biases. Integrating the self-immersion framework with the selective accessibility model (SAM), we propose that rudeness-induced negative arousal will narrow individuals' perspectives in a way that will make anchoring more likely. Additionally, we posit that perspective taking and information elaboration will attenuate the effect of rudeness on both negative arousal and subsequent anchoring. Across four experimental studies, we test the impact of exposure to rudeness on anchoring as manifested in a variety of tasks (medical diagnosis, judgment tasks, and negotiation). In a pilot study, we find that rudeness is associated with anchoring among a group of medical students making a medical diagnosis. In Study 1, we show that negative arousal mediates the effect of rudeness on anchoring among medical residents treating a patient, and that perspective taking moderates these effects. Study 2 replicates the results of Study 1 using a common anchoring task, and Study 3 builds on these results by replicating them in a negotiation setting and testing information elaboration as a boundary condition. Across the four studies, we find consistent evidence that rudeness-induced negative arousal leads to anchoring, and that these effects can be mitigated by perspective taking and information elaboration. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The effects of rudeness, experience, and perspective-taking on challenging premature closure after pediatric ICU physicians receive hand-off with the wrong diagnosis: a randomized controlled simulation trial.

OBJECTIVES: Rudeness exposure has been shown to inhibit diagnostic performance. The effects of rudeness on challenging a handed-off diagnostic error has not been studied. METHODS: This was a randomized controlled study of attending, fellow, and resident physicians in a tertiary care pediatric ICU. Participants underwent a standardized simulation that started with the wrong diagnosis in hand-off. The hand-off was randomized to neutral vs. rude. Participants were not informed of the randomization nor diagnostic error prior to the simulation. Perspective taking questionnaires were administrated for each participant. Primary outcome was challenging diagnostic error post-simulation. Secondary outcomes included rate and frequency of diagnostic error challenge during simulation. RESULTS: Among 41 simulations (16 residents, 14 fellows, and 11 attendings), the neutral group challenged the diagnostic error more than the rude group (neutral: 71%, rude: 55%, p=0.28). The magnitude of this trend was larger among resident physicians only, although not statistically significant (neutral: 50%, rude: 12.5%, p=0.11). Experience was associated with a higher percentage of challenging diagnostic error (residents: 31%, fellows: 86%, attendings: 82%, p=0.003). Experienced physicians were faster to challenge diagnostic error (p<0.0003), and experience was associated with a greater frequency of diagnostic error challenges (p<0.0001). High perspective taking scores were also associated with 1.63 times more diagnostic error challenges (p=0.007). CONCLUSIONS: Experience was strongly associated with likelihood to challenge diagnostic error. Rudeness may disproportionally hinder diagnostic performance among less experienced physicians. Perspective taking merits further research in possibly reducing diagnostic error momentum.

How witnessing rudeness can disrupt psycho-motor performance of dental students.

Rude and disrespectful behaviors are ubiquitous and pervasive in the workplace. The purpose of this study was to examine the effects of witnessed rudeness on dental student psychomotor performance. Using an experimental, between-subjects design, 71 2nd (Sophomore) year dental students witnessed either an experimental (rude) or control (neutral) condition in which a confederate lab manager interacted in a rude or neutral manner with a prospective lab assistant candidate. Students then performed a mock prosthodontics psychomotor examination as part of the fixed prosthodontics preclinical course. Results indicated that those students who arrived at the experimental session cognitively depleted (+1 SD above the mean) and were exposed to the rude condition were significantly more likely to make critical errors when performing a posterior bridge preparation, compared to those students in the control group. There were no significant differences between the rude and control conditions for participants who were not cognitively depleted (-1 SD below the mean). Overall, the findings indicate that for those dental students suffering from cognitive depletion, merely witnessing rudeness can have adverse impacts on psychomotor performance and potentially, eventual patient care.

Expressions of Gratitude and Medical Team Performance.

BACKGROUND AND OBJECTIVES: Exposure to negative social interactions (such as rudeness) has robust adverse implications on medical team performance. However, little is known regarding the effects of positive social interactions. We hypothesized that expressions of gratitude, a prototype of positive social interaction, would enhance medical teams' effectiveness. Our objective was to study the performance of NICU teams after exposure to expressions of gratitude from alternative sources. METHODS: Forty-three NICU teams (comprising 2 physicians and 2 nurses) participated in training workshops of acute care simulations. Teams were randomly assigned to 1 of 4 conditions: (1) maternal gratitude (in which the mother of a preterm infant expressed gratitude to NICU teams, such as the one that treated her child), (2) expert gratitude (in which a physician expert expressed gratitude to teams for participating in the training), (3) combined maternal and expert gratitude, or (4) control (same agents communicated neutral statements). The simulations were evaluated (5-point Likert scale: 1 = failed and 5 = excellent) by independent judges (blind to team exposure) using structured questionnaires. RESULTS: Maternal gratitude positively affected teams' performances (3.9 ± 0.9 vs 3.6 ± 1.0; P = .04), with most of this effect explained by the positive impact of gratitude on team information sharing (4.3 ± 0.8 vs 4.0 ± 0.8; P = .03). Forty percent of the variance in team information sharing was explained by maternal gratitude. Information sharing predicted team performance outcomes, explaining 33% of the variance in diagnostic performance and 41% of the variance in therapeutic performance. CONCLUSIONS: Patient-expressed gratitude significantly enhances medical team performance, with much of this effect explained by enhanced information sharing.

Incivility and Patient Safety: A Longitudinal Study of Rudeness, Protocol Compliance, and Adverse Events.

BACKGROUND: Little is known about the impact of social interactions on iatrogenesis and lapses in patient safety. METHODS: This field-based experience-sampling study of primarily nurses in a general hospital explored the impact of rudeness on patient safety performance, state depletion (that is, exhaustion of mental energy for reflective behavior), and team processes (for example, information sharing). Objective measures of performance were compliance with hand hygiene and medication preparation protocols, as well as archival reports of adverse events. Data were analyzed by department shift (480 shifts [15 days] in 16 departments). RESULTS: A total of 231 rudeness incidents were reported in 98 shifts, most stemming from a patient or family. Compliance with hand hygiene was significantly lower up to 24 hours after rudeness exposure (p = 0.03). Rudeness significantly increased team members' state depletion (p = 0.002) and was associated with decreased information sharing (p = 0.046) but was not directly associated with adverse events or level of compliance with medication and hand hygiene protocols. However, the adverse indirect effect of shifts' temporal proximity to rudeness on poor compliance with medication preparation and team members' information sharing via state depletion was significant. Rudeness exposure was also associated with increased rate of adverse events in the subsequent 24 hours, although this association was not statistically significant. CONCLUSION: Rudeness exposure was associated with reduced team member compliance with infection control and medication protocols via greater team member state depletion and diminished information sharing.