A controlled adaptive computational network model of a virtual coach supporting speaking up by healthcare professionals to optimise patient safety

Shaney Doornkamp, Fakhra Jabeen, Jan Treur, H. Rob Taal, Peter Roelofsma

Research output: Contribution to journalArticleScientificpeer-review

1 Downloads (Pure)


Previous reports show that a substantial proportion of (near) medical errors in the operating theatre is attributable to ineffective communication between healthcare professionals. Speaking up about observed medical errors is a safety behaviour which promotes effective communication between health care professionals, consequently optimising patient care by reducing medical error risk. Speaking up by healthcare professionals (e.g., nurses, residents) remains difficult to execute in practice despite increasing awareness of its importance. Therefore, this paper discourses a computational model concerning the mechanisms known from psychological, observational, and medical literature which underlie the speaking up behaviour of a health care professional. It also addresses how a doctor may respond to the communicated message. Through several scenarios we illustrate what pattern of factors causes a healthcare professional to speak up when witnessing a (near) medical error. We moreover demonstrate how introducing an observant agent can facilitate effective communication and help to ensure patient safety through speaking up when a nurse can not. In conclusion, the current paper introduces an adaptive computational model which predicts speaking up behaviour from the perspective of the speaker and receiver, with the addition of a virtual coach to further optimise patient safety when a patient could be in harm's way.
Original languageEnglish
Pages (from-to)37-49
Number of pages13
JournalCognitive Systems Research
Publication statusPublished - 2023

Bibliographical note

Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.


  • Adaptive network modelling
  • Healthcare
  • Patient safety
  • Psychological safety
  • Speaking up

Cite this