New Medical Advisor a Champion of Collaboration

Dr. Saroo Sharda, new CPSO medical advisor, puts focus on interprofessional communications

Dr. Saroo Sharda was drawn to anesthesiology because of the specialty’s reputation as an agent for patient safety. Her own contribution to patient safety has been focused on enhancing how health-care teams work together to deliver emergency care.

“Being able to communicate well, particularly in an emergency situation or a situation of potential conflict, is a skill set which needs to be given as much respect and time as any other skill set, if not more,” said Dr. Sharda, who recently joined the College as a medical advisor., She is also an assistant clinical professor at McMaster University and an Anesthesiologist and Obstetrical Anesthesia Lead at the Oakville Trafalgar Memorial Hospital and holds a Masters and Fellowship in Medical Education.

At the Centre for Simulation Based Learning at McMaster University, Dr. Sharda uses computer-driven manikins that breathe, blink, speak, bleed and even give birth during low-frequency, high-stakes medical events to teach residents from anesthesia, surgery, and obstetrics.

Dr. Sharda recently collaborated with stakeholders at her hospital to bring this technology to the environment in which health-care teams actually work. Surgeons, anesthesiologists, nurses, anesthesia assistants, midwives and lab technicians all participate in simulated emergencies in their own operating rooms and labour and delivery units to promote the delivery of high-quality patient care. She has also helped other hospitals develop similar programs. During the COVID-19 pandemic, Dr. Sharda has noted how crucial these types of simulations and drills have been in preparing teams for high-stakes, uncertain situations.

But it is not so much the technical skills that Dr. Sharda is observing. Her attention is focused on how health-care professionals interact during the simulation. If someone appears too intimidated to alert others to an emerging concern, for example, Dr. Sharda will discuss it later, during her debriefing. She makes those conversations as productive as possible so that the participants can have a deeper understanding of each others’ roles, and an awareness of the value of coordinated decision-making.

Colleagues will often approach her after a debrief and say things like, ‘I had no idea I come across like that in an emergency’.

While Dr. Sharda often teaches in high technical fidelity simulation environments, she uncovered in her research that other types of fidelity are just as important. For example, she published a paper which coined the term ‘sociological fidelity’ to address those real life interprofessional tensions, hierarchies and boundaries that need to be taken into account in the design of simulations.

“We cannot ever completely dispose of that hierarchy, and in fact some degree of hierarchy and leadership is necessary in an acute situation, but we can teach folks communication strategies to reduce the potential negative effects of the power dynamics that exist. We need to maintain a spirit of curiosity and respect for every person we work with, including our patients, if we want to deliver safer and more effective care,” said Dr. Sharda.

In fact, she said, colleagues will often approach her after a debrief and say things like, ‘I had no idea I come across like that in an emergency. I am going to change the way I say that.’

She said that she finds it extremely satisfying to bring professionals together for these kinds of productive discussions. “In the busyness of our day to day work, it is not often we get to sit in a room together, nurses, doctors, other health-care professionals, and talk about what is working and what isn’t. Folks find that opportunity to pause and connect, extremely powerful. And that is critically important because ultimately it leads better care for our patients,” she said

In fostering collaborative teamwork and communication, her work has realized tangible patient safety advances — including the development of a structured tool for more effective interprofessional communication around the urgency of cesarean sections, better labelling of and access to certain emergency drugs, access to high quality cognitive aids to help decision making in emergency situations, and development of protocols for the management of patients in the OR and labour and delivery during COVID-19.

That she would be so adept as a communicator does not surprise those who know of her other passion besides medicine — creative writing. Her writing is influenced by her roles as mother, wife (to a fellow doctor), writer, spiritual seeker and of course, physician. She is also a trained creative writing coach and facilitates narrative medicine workshops for anesthesiologists and other health-care professionals.

“Opening up conversations about how we are doing, particularly during COVID-19, is a crucial part of combating burnout. Burnt out physicians cannot provide high quality care,” says Dr. Sharda, who recently became the Inaugural Chair of the Physician Wellness Committee at the Canadian Anesthesiologists’ Society.

In a much-tweeted essay in The Globe and Mail titled “The Forgotten Physician,” Dr. Sharda allows herself to lament — briefly — about the invisibility of her specialty.

But Dr. Sharda has no regrets about her choice. “There are so many instances when I am overcome with gratitude at being able to do this work,” she said.