March 4, 2015By Lance Baily

'Simulation Discomfiters' – The Anti-Champions Who Frustrate Our Programs

healthcare egos

I looked up the definition of champion today. Words like “supporter”, “booster”, “friend”, “hero”, and “superstar” were among my favorites — and all words I feel when I think of the thousands of simulation champions I have met over the past many years. Below these great words I saw the antonyms of champion, which included words like “trivial”, “worst”, “least” and “discomfit”.

Discomfit was a word I had never heard before. It means “1. to make uneasy, confused, or embarrassed 2. to frustrate the plans or purpose of”. A discomfiter, therefore, is a person who makes things difficult, confusing, and embarrassing while frustrating the plans and purposes of a team.


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On various occasions I have directly witnessed one individual’s ego take down an entire healthcare simulation program. As a community builder in our field of simulation, I have had countless phone calls with champions from around the world who share their grief and frustration over the constant roadblocking by another member of their team — a discomfiter who is usually set in their ways unable to truly adopt the change required for technical and learning innovation to occur. Whether its spreading rumors, continually demanding attention, discrediting and threatening others, or just ignoring contributions — these discomfiters do exist. Sadly, sometimes a discomfiter’s constant complaining and negative energy succeeds and they get their way which leads to the eviction of champions and the reduction of simulation.

Usually within three to six months after such a tragic event, I learn from the champion that the simulation program has suffered a great deal – with learning outcomes and operational efficiency diminishing sometimes down to nothing. Literally, a single personnel change and within six months a robust simulation program with huge learner impacts turns into wasted equipment, spaces, and time.

For some of us in smaller programs we are the entire simulation team. I’m sure you’ve wondered what would happen if you needed to find work elsewhere — but has your administration? How much knowledge and expertise walks out the door with you — especially when you do not have the opportunity to train your replacement.

Dr. Val Gokenbach, Professor for American Sentinel University in the DNP, MSN and BSN programs, wrote an article for NurseTogether.com called Lose the Ego Nurses, It’s Not About You“. In her article Dr. Gokenbach shares that “as an administrator for over 35 years in healthcare organizations, I have seen ego destroy individuals, ruin reputations, hinder personal growth and success”. (Nursing is just one example of where unchecked egos and unprofessional communication can cause problems, but such challenges exist throughout healthcare including patient vs doctor, nurse vs doctor, and even police officer vs. fire fighter engagements).


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Dr. Gokenback explains the ego and the impact that ego can have on our lives and our programs when left unchecked: “Our ego is constantly threatened by the perception of others and is always in need of attention. Anything that threatens that security can become a basis for conflict, anger, and fear. The reality is that we all have egos. The successful nurse learns to realize the concept, protect themselves emotionally, and control their reaction.”

Ultimately in the workplace administrators have the responsibility to check egos and ensure that the program, simulation or otherwise, can continue to innovate and succeed. Tools that are available to help us with this delicate situation like signing up for the TeamSTEPPS Communication System Free Online Master Training or taking time to reflect on healthcare team communication with new books like Collaborative Caring by S. Gordon.

I faced such issues myself as the first director of the Clinical Simulation Center of Las Vegas. Primarily I quietly relied on one primary question to help me decipher if challengers where champions of discomfiters: does this person’s request benefit the simulation program, or benefit the person?

Dr. Gokenback’s advice to such discomfiters? “Get over yourself. Think of your importance to the greater good and not only your world, which is small in comparison.” Read her full article here.

Have you dealt with a “discomfiter” in your simulation career?
Share about your experience on the HealthySim LinkedIn Discussion Group!


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