Jenny W Rudolph

Jenny W Rudolph
Massachusetts General Hospital | MGH · Department of Anesthesia, Critical Care and Pain Medicine

PhD

About

61
Publications
42,757
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
5,237
Citations
Introduction
Jenny Rudolph, PhD is a life-long athlete who brings the joy of mastery learning to team performance in healthcare. Dr. Rudolph is an organization behavior scholar on the faculty of Massachusetts General Hospital Department of Anesthesia Critical Care and Pain Medicine, and department of Anaesthesia at Harvard Medical School. She serves as the Executive Director of the Center Medical Simulation which is dedicated to improving quality and safety in healthcare through experiential education.
Additional affiliations
September 2007 - present
Harvard Medical School
Position
  • Research Assistant
September 2002 - July 2007
Boston University
Position
  • Professor (Assistant)
Education
September 1995 - June 2002
Boston College, USA
Field of study
  • Organization Studies
September 1980 - June 1985
Harvard University
Field of study
  • Sociology

Publications

Publications (61)
Article
Full-text available
Introduction When there is miscommunication and poor coordination between experienced clinician dyads, teamwork suffers. Research on expert learning practices for the smallest team, and arguably the most important team, the healthcare dyad, is limited. The objective of this study is to map the extent and range of evidence available on learning prac...
Article
Full-text available
“Circle Up,” an inexpensive, easy-to-implement, and broadly-applicable process for coordinating clinical care, uses brief and inspirational planning or after-action conversations like those convened by sports coaches or platoon leaders to improve both care quality and the mental health of the staff
Article
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 t...
Article
Introduction The demand for highly skilled simulation-based healthcare educators (SBEs) is growing. SBEs charged with developing other SBEs need to be able to model and conduct high-quality feedback conversations and ‘debrief the debriefing’. Direct, non-threatening feedback is one of the strongest predictors of improved performance in health profe...
Chapter
Full-text available
Introduction and objective: Simulation is used for training physicians by practicing cognitive skills in situations of crisis and for identifying problems by constructive resolution. Sepsis is a disease whose incidence and mortality are high. The use of simulation was evaluated in comparison with traditional education, in order to improve adherence...
Article
Full-text available
Starting with the premise that subteam psychological safety (PS) microclimates are vitally important to team behavior yet invisible to team-level PS concepts and measures, we introduce a multilevel theory and model of PS within work teams. We first demonstrate the inevitability and influence of distinct PS microclimates in teams and highlight the l...
Article
Full-text available
Statement: 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 a...
Article
Purpose: The authors addressed three questions: (1) Would a realistic simulation-based educational intervention improve speaking-up behaviors of practicing nontrainee anesthesiologists? (2) What would those speaking-up behaviors be when the issue emanated from a surgeon, a circulating nurse, or an anesthesiologist colleague? (3) What were the hurd...
Article
Background: Realising the full potential of the WHO Surgical Safety Checklist (SSC) to reduce perioperative harm requires the constructive engagement of all operating room (OR) team members during its administration. To facilitate research on SSC implementation, a valid and reliable instrument is needed for measuring OR team behaviours during its...
Article
Statement: As part of simulation-based education, postevent debriefing provides an opportunity for learners to critically reflect on the simulated experience, with the goal of identifying areas in need of reinforcement and correcting areas in need of improvement. The art of debriefing is made more challenging when 2 or more educators must facilita...
Article
In the absence of theoretical or empirical agreement on how to establish and maintain engagement in instructor-led health care simulation debriefings, we organize a set of promising practices we have identified in closely related fields and our own work. We argue that certain practices create a psychologically safe context for learning, a so-called...
Article
The PDF can be downloaded from https://www.revespcardiol.org/es-theories-and-styles-of-debriefing-articulo-S0300893214003868
Article
Debriefing is a rigorous reflection process which helps trainees recognize and resolve clinical and behavioral dilemmas raised by a clinical case. This approach emphasizes eliciting trainees’assumptions about the situation and their reasons for performing as they did (mental models). It analyses their impact on actions, to understand if it is neces...
Article
Debriefing is a rigorous reflection process which helps trainees recognize and resolve clinical and behavioral dilemmas raised by a clinical case. This approach emphasizes eliciting trainees'assumptions about the situation and their reasons for performing as they did (mental models). It analyses their impact on actions, to understand if it is neces...
Article
Although feedback conversations are an essential component of learning, three challenges make them difficult: the fear that direct task feedback will harm the relationship with the learner, overcoming faculty cognitive biases that interfere with their eliciting the frames that drive trainees' performances, and time pressure. Decades of research on...
Article
IntroduccIón: la simulación se utiliza para entrenar a los médicos y practicar las habilidades cognitivas en situaciones de crisis e identificación de problemas con resolución constructiva. La sepsis es una enfermedad con incidencia y mortalidad altas. Se evaluó el uso de la simulación en comparación con la educación tradicio- nal, para mejorar la...
Article
Full-text available
Starting with the premise that subteam psychological safety (PS) microclimates are vitally important to team behavior yet invisible to team-level PS concepts and measures, we introduce a multilevel theory and model of PS within work teams. We first demonstrate the inevitability and influence of distinct PS microclimates in teams and highlight the l...
Article
Simulation instructors often feel caught in a task-versus-relationship dilemma. They must offer clear feedback on learners' task performance without damaging their relationship with those learners, especially in formative simulation settings. Mastering the skills to resolve this dilemma is crucial for simulation faculty development. We conducted a...
Article
Full-text available
Background: Actionable feedback targeted to the learner's needs is one of the strongest predictors of improved performance in learning. Unfortunately, when a trainee makes an error, although instructors may understand what a trainee has done wrong, they can erroneously assume they know why. Context: There is a growing recognition that cognitive...
Chapter
Full-text available
Debriefing is the learning conversation that follows a simulation session. The instructor’s role in providing feedback and guiding reflection is critical to ensure that reflecting on the simulation experience yields learning and growth in accordance with the stated educational goals of the session. This chapter describes the philosophy of “Debriefi...
Article
Motivated by a medical diagnosis problem that generates a wide range of problem-solving behaviors, three social scientists with different domains of expertise and different perspectives collaborated using a system dynamics modeling approach to do theory building in the social sciences. The collaboration led to a model of dynamic problem solving gro...
Article
Full-text available
INTRODUCTION: This study examined the reliability of the scores of an assessment instrument, the Debriefing Assessment for Simulation in Healthcare (DASH), in evaluating the quality of health care simulation debriefings. The secondary objective was to evaluate whether the instrument's scores demonstrate evidence of validity. METHODS: Two aspects of...
Article
Organizational behavior and management fields have long realized the importance of teamwork and team-building skills, but only recently has health care training focused on these critical elements. Communication styles and strategies are a common focus of team training but have not yet been consistently applied to medicine. We sought to determine wh...
Article
ACADEMIC EMERGENCY MEDICINE 2011; 18:1246–1254 © 2011 by the Society for Academic Emergency Medicine This article presents a model of how a build-up of interruptions can shift the dynamics of the emergency department (ED) from an adaptive, self-regulating system into a fragile, crisis-prone one. Drawing on case studies of organizational disasters a...
Article
Over the past decade, medical simulation has evolved into an essential component of pediatric resuscitation education and team training. Evidence to support its value as an adjunct to traditional methods of education is expanding; however, large multicenter studies are very rare. Simulation-based researchers currently face many challenges related t...
Article
Full-text available
We offer a theory of action-oriented problem solving that links interpretation and choice, processes usually separated in the sensemaking literature and decision-making literature. Through an iterative, simulation-based process we developed a formal model. Three insights emerged: (1) action-oriented problem solving includes acting, interpreting, an...
Article
Residents train in a historically hierarchical system. They may be compelled to question their teachers if they do not understand or disagree with a clinical decision, have a patient safety concern, or when treatment plans are unclear. We sought to determine whether a debriefing intervention that emphasizes (1) joint responsibility for safety and (...
Article
The authors present a four-step model of debriefing as formative assessment that blends evidence and theory from education research, the social and cognitive sciences, experience drawn from conducting over 3,000 debriefings, and teaching debriefing to approximately 1,000 clinicians worldwide. The steps are to: 1) note salient performance gaps relat...
Article
Full-text available
Sensegiving—shaping how people understand themselves, their work, and others engaged in that work—is critical to the work of organizational leadership. We propose the “cognitive shift,” a change in how an organizational audience understands an important element of the organization's work, as a desired outcome of the sensegiving process. Organizatio...
Chapter
Full-text available
This chapter describes an approach for teaching reflective practice in the action science/action inquiry tradition. We offer a theoretical background for our approach and then break it down into three key stages: (1) understanding the social construction of reality; (2) recognizing one's own contribution to that construction; and (3) taking action...
Article
Full-text available
Building on in-depth studies of diagnostic problem solving in a time-pressured acute care setting, we develop a formal mathematical model of the dynamic structures that underlie four diagnostic archetypes. We clarify the mechanisms that facilitate and prevent switching between and combining exploring diagnoses and exploiting known treatments. This...
Article
Drawing on theory and empirical findings from a 35-year research program in the behavioral sciences on how to improve professional effectiveness through reflective practice, we develop a model of "debriefing with good judgment." The model specifies a rigorous reflection process that helps trainees surface and resolve pressing clinical and behaviora...
Article
Full-text available
To improve safety performance, many healthcare organizations have sought to emulate high reliability organizations from industries such as nuclear power, chemical processing, and military operations. We outline high reliability design principles for healthcare organizations including both the formal structures and the informal practices that comple...
Article
Full-text available
The abstraction hierarchy analysis tool developed by Vicente and Rasmussen (1992) for Ecological Interface Design (EID) provides an in depth understanding of work domain constraints and information requirements. EID and work domain analysis (WDA) have been successfully applied in several fields. However, application in the medical domain has proven...
Article
Full-text available
This study focuses on the interpretations and experiences of change recipients, those who carry out organizational interventions initiated by others. Based on the ways nurses experienced a shared governance initiative implemented in their hospital, the authors investigated change recipients’ sensemaking about organizational change through their asc...
Article
Full-text available
This article uses conversational processes to advance idea development related to researching socially disapproved organizational behavior (SDOB). Ideas are grounded both in the authors' individual experiences researching such “tainted topics” and in insights that emerged through conversation about their research process related to SDOB. The transc...
Article
We report on our experience with an approach to debriefing that emphasizes disclosing instructors' judgments and eliciting trainees' assumptions about the situation and their reasons for acting as they did. To highlight the importance of instructors disclosing their judgment skillfully, we call the approach "debriefing with good judgment." The appr...
Article
Full-text available
Learning-in-action, the cyclical interplay of thinking and doing, is increasingly important for organizations as environments and required capabilities become more complex and interdependent. Organizational learning involves both a desire to learn and supportive structures and mechanisms. We draw upon three case studies from the nuclear power and c...
Article
Learning from experience, the cyclical interplay of thinking and doing, is increasingly important as organizations struggle to cope with rapidly changing environments and more complex and interdependent sets of knowledge. This paper confronts two central issues for organizational learning: 1.(1) how is local learning (by individuals or small groups...
Article
Full-text available
Root cause analysis was introduced to a chemical plant as a way of enhancing performance and safety, exemplified by the investigation of an explosion. The cultural legacy of the root cause learning intervention was embodied in managers' increased openness to new ideas, individuals' questioning attitude and disciplined thinking, and a root cause ana...
Article
La finalité de notre article est de comprendre la nature et la diversité des relations intervenant dans le processus de diffusion interorganisationnelle des connaissances. Notre questionnement porte dans un premier temps sur la nature des dimensions de ces relations et dans un second temps sur leur diversité. L’intérêt est double : préciser et comp...
Article
Full-text available
This article examines the role that the quantity of non-novel events plays in precipitating disaster through the development of a formal (mathematical) system-dynamics model. Building on existing case studies of disaster, we develop a general theory of how an organizational system responds to an on-going stream of non-novel interruptions to existin...
Article
High-hazard or high-reliability organizations are ideal for the study of organizational learning processes because of their intense mindfulness regarding problems. We examine 27 problem investigation teams at 3 nuclear power plants whose task was to report to management about causes and corrective actions and thereby contribute to organizational le...
Article
Full-text available
This paper reports an action research study in which we applied Edgar Schein's process consultation approach to a cross-functional problem in a large academic teaching hospital. The project task force was charged with investigating a hypothesized effect of poor lab turnaround time on the risk of probable discharges being postponed until the followi...