Medical University of South Carolina: Students get "Just Culture" in their MHA Program

CHARLESTON, SC – Health care administration professionals, who must carefully consider how they evaluate human errors and at-risk behaviors in health care practice by those they manage, often struggle with knowing the best way to encourage transparency and accountability for those errors. To address this knowledge gap in training for health administrators about to hit the workforce, the MUSC College of Health Professions (CHP) piloted a new curriculum approach for this year’s Master in Health Administration (MHA) graduating class that incorporated the Just Culture system of workplace accountability for high-consequence industries. It is the only program in the country to date to offer this additional training and research opportunity to its MHA students.

“Over the years, I have asked former graduate students what they felt unprepared for when they got into the real world of leading individuals within a health care entity,” said Tom Crawford, Ph.D., MHA program assistant professor.  “The answer was the delicate interaction with their employees when things did not go as planned.” To that end, Crawford and his colleagues constructed a curriculum using “Dave’s Subs: A Novel Story About Workplace Accountability” and partnered with the book’s author and Outcome Engenuity principal, David Marx, for a research and education project to develop and refine academic materials and testing related to Just Culture.

Recognized by industry leaders as the “father of the Just Culture movement,” Marx said that Just Culture is about differentiating human errors and at-risk behaviors from more culpable and reckless choices that providers may make in the course of caring for patients. “It works to move away from judging employees based upon an unfortunate outcome, putting more emphasis on the quality of their choices.  In doing this, we create a more accountable, open, learning culture within an organization – which in turn leads to better outcomes,” he said.

MHA students were provided an opportunity to take the Just Culture Certification exam, and provided feedback on the exam and curriculum throughout the educational partnership. Student Parker Rhoden, who recently passed the exam, said, “The Just Culture certification provided me with a framework to effectively handle difficult human resources decisions, and will be extremely valuable to my career in health administration. This really is an immediate benefit for those of us entering the workplace.” 

Jami DelliFraine, Ph.D., CHP Department of Healthcare Leadership and Management chairwoman, echoed Rhoden’s comments. “We see this as an opportunity to bring the incredibly important message of Just Culture to tomorrow’s health care leaders, and through our continuing education program to leaders within the broader community,” she said.