“Excuse Me:” Teaching Interns to Speak Up

The willingness to share examples of poor performance is an important part of building a good safety culture. Listening to the stories of attendings describing and reflecting on a situation in which they struggled is a powerful teaching method for training interns in the communication and assertiveness skills that are critical to their job. However, a sustained change in attitudes and behavior to speaking up will require a reinforcement of learning with deliberate practice to develop the skills introduced through the training program.