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Table 3 Typology of indirect challenges

From: “The patient is awake and we need to stay calm”: reconsidering indirect communication in the face of medical error and professionalism lapses

Typology of indirect challenges

Participant example

Expressing personal uncertainty or discomfort

“Could you show me how or could you perform it because I don’t feel comfortable?” OBR006, interview

Reframing challenges as an educational question

“If I think that they’re not doing the right thing, I try and phrase it in like, ‘for my own learning because I don’t know’” OBR009, interview

Providing facts without judgment

“Sometimes … the nurse will say something similar to, ‘the heart rate’s been down at 60 for 3 min now.’ … it gives me a little nudge to say, ‘okay, let’s stop waiting, let’s act.’ Because sometimes when things are happening like that, you get a sense of tunnel vision, and you don’t see the bigger picture. FP008, interview

Non-verbal cues

“Or sometimes you get in the room, and the nurse has already got the O.R. pack stamped up for a C-section, and you’re like, I think I know what you’re thinking.” OB009, interview