David Grant

3/3
Then applied to safety:
Ontology = work as done
epistemology = accident models
phenomenology = safety climate or safety culture of an organisation.

Thoughts
@siriwiig.bsky.social @carlhorsley.bsky.social ley.bsky.social @davidjvaughan.bsky.social

2/3
If we accept that ontology describes what reality exists, epistemology describes how we can obtain knowledge of that reality and phenomenology describes the nature of our experience of that reality (how we perceive or understand it).

A framework for understanding risk based on the concepts of ontology and epistemology Two fundamental philosophical concepts of social science are ontology (idealism and realism), relating to what reality is, and epistemology (epistemological realism, epistemological idealism), rela...

1/3 Reflections on relation of philosophical concepts to #Risk & #Patient #Safety.
Ylönen, M., & Aven, T. (2023). A framework for understanding risk based on the concepts of ontology and epistemology. Journal of Risk Research, 26(6), 581–593. doi.org/10.1080/1366...

Expanding from this. Potential for learning is increased if we frame events as successes (a good catch) rather than near misses! Yet in healthcare we perpetually use term near miss.

I have seen ➕impact of #LearningFromExcellence but am stuck by work of Staat & Gino showing that individual learning ⬆️ from own successes rather than failures, but we learn more from failures of others than their successes. Thoughts? psycnet.apa.org/record/2013-...

It strikes me that the number of narcissistic leaders in the world has been increasing. This is deeply concerning as the literature tells us they are likely to be led by their ego rather than rational logical thinking that remains sensitive to the adverse impacts of their actions.

It appears some lessons have to be learnt again. It’s just a shame decisions are made for those those who are most at risk before they have chance to decide for themselves.

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Privilege to deliver introductory lecture of Bristol Med School integrated SafeTI Systems Curriculum in such a beautiful setting this morning. Arming these students over their first 3 years with knowledge and tools to deliver #Safe healthcare within a complex adaptive #Systems
#preperationiskey

Wow beautiful. Is that from today? If so your weather is much better than ours here in Bristol! 😂

Nope

This platform needs a giggle response in addition to like. Thank you for making me smile on a morning my alarm failed to go off.

Agreed. Approach described in direct contrast to all widening participation efforts we implement to diversify students we recruiting to our medical school. To minimise potential for this bias we did away with personal statements and focussed on personal development and growth through interviews.

Oh dear that should have read *great example……

Her actions were the embodiment of integrity and courage - gray example for all

“When we know what is true, it’s incumbent upon us to speak the truth even when, especially when, it costs us”

Rt Rev Mariann Budde

@carlhorsley.bsky.social @kencatchpole.bsky.social @davidjgrant.bsky.social @janekohara.bsky.social @siriwiig.bsky.social @trishgreenhalgh.bsky.social

Agree. Photo below is me in my slippers and shorts delivering keynote at international conference during COVID. 😂

Sounds like a good recipe to encourage cognitive dissonance where desire to act morally is balanced with desire to succeed. Eventually resulting in rationalisation of behaviours to resolve dissonance in favour of mental wellbeing. A sort of efficiency thoroughness trade off.

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8/8 The Do Not's:
- Mask statements as questions
- Use questions to cross examine

7/8 The how to:
- Move from i understand to help me understand
- Ask questions to learn not contradict
- Parafrase to reach clarity
- Acknowledging views does not = agreement
- when seemingly disagree ➡️ seek to understand the reasoning that underpins the other persons statement first.

6/8
Be authentic - be truly curious and caring.
Listening is only powerful and effective if it is authentic.

5/8
Our cognitive biases will lead us to snap conclusions/judgement - trick is to be aware of it but not allow it to drown out the other person’s voice.

Remind yourself your role is to understand the other person’s reality and that can only be done by them communicating it to you.

4/8
Listening to understand conveys not only intent to achieve mutual understanding, but signals mutual respect - factors that, when combined with curiosity, facilitate more insightful reflection that allows/enables deeper understanding that cannot be achieved in isolation.

3/8
It is important to not only acknowledge explicit communication (what is said) , but also what is implicitly communicated (such as emotions).

2/8
The primary focus of communicator is to construct & communicate comprehend-able message. The absence of acknowledgement of receipt/comprehension by receiver prohibits them from listening to receiver as their focus is on finding new ways of communicating it - hence both end up feeling unheard.

🧵1/8 Reflections on impact of listening to understand during conversations based on Difficult conversations by Stone et al & past experiences:

Meaningful conversations require us to build rapport or a relationship with each other

It is a fundamental human need to feel heard, understood & validated