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The challenge of challenging others: speaking up behaviour in interprofessional clinical teams




The Centre for Mental Health Research presents:

Speaker Dr Mary Lavelle


The effective and safe provision of healthcare relies on multiple professionals, from different healthcare disciplines, working together for a common goal. This can only be achieved through good communication and co-ordination between team members. The ability to ‘speak up’ when lapses or errors in teammates’ performance are observed has been identified as a critical component of effective teamworking both in theoretical models of teamwork and through empirical studies. However, in practice, speaking up to challenge colleagues’ performance may be difficult to achieve for a variety of reasons, including: cultural and educational differences between professions; perceived and actual hierarchies; staff attitudes and perceptions of interprofessional working and the transient and episodic nature of teams in clinical settings.  As an alternative strategy to speaking up, healthcare staff report employing other, more subtle, communication strategies in response to concerns including manipulation of speech and tactical use of silence. However, little is known about the presentation or effectiveness of these implicit challenges.

Through detailed observational analysis of simulated interprofessional clinical scenarios, the aim of this study was to explore how challenges to others’ performance are negotiated in interprofessional clinical teams, specifically examining, which team members address the performance of which colleagues, the communication behaviors used to achieve this and the impact of such challenges on those they are directed towards. The preliminary findings of this work will be presented.


Dr Mary Lavelle is a Senior Research Fellow in Mental Health in the School of Health Sciences at City, University of London. Her research interests are focused on how people engage in social interaction. Mary completed her PhD at Queen Mary University, where she employed 3D motion capture techniques to investigate social deficits in psychosis. From here she moved to King’s College London and then Imperial College London, where she has been conducting research to examine the communication of clinical teams in the context of patient safety and organisational resilience. At City, Mary hopes to build on this work investigating the complex dynamics of social interaction, both in clinical teams in mental health settings and in clinical populations marked by social impairment.

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When and where

12.30pm - 2.00pmMonday 24th June 2019

MG26 Myddelton Street Building City, University of London 1 Myddelton Street London EC1R 1UW United Kingdom