A Behavioural Study of Obedience in Health Professional Students

• Author / Creator

  Violato, Efrem M

• The research in this dissertation draws on theories from psychology to address the issue of obedience as it relates to medical error and patient harm in healthcare settings by developing a model of obedience, analyzing the environment of application through survey research, and testing obedience in a simulated compliance scenario. The first chapter presents an overview of the dissertation and a review of literature on compliance in healthcare and related topics. In the second chapter a model for obedience is developed drawing on relevant psychological theories. The third chapter reports on survey data gathered to better understand healthcare environments, showing both obedience to authority and conformity are frequently encountered, with Impression Management, Displacement of Responsibility, and Moral Distress being contributing factors. In the fourth chapter to explore causative mechanisms of obedience to authority an experimental simulated compliance scenario was used with Respiratory Therapy and Advanced Care Paramedic students. An intervention to increase positive deviance did not have a significant effect. Low cognitive load reduced the rate of positive deviance in Respiratory Therapy students. The fifth chapter reports on students’ experiences during the simulation scenario. Impression Management, Displacement of Responsibility, and Moral Distress were found to be important factors for obedience to authority, aligning with results presented in chapter three. The combined research is an initial step towards a more refined understanding of obedience to authority in healthcare. In Group Loyalty and experience appear to be important factors in determining if a person will engage in positive deviance while Cognitive Load and Respect for Authority did not function as expected. Within the overarching consideration of patient safety, future research, and practical approaches to promoting positive deviance through education are discussed, including a three-step approach that may be integrated into existing curriculum.

• Subjects / Keywords

  • Health Professions
  • Obedience
  • Compliance
  • Patient Safety
  • Education

• Graduation date

  Spring 2022

• Type of Item

  Thesis

• Degree

  Doctor of Philosophy

• DOI

  https://doi.org/10.7939/r3-0zcr-5282

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.