Resilience skills as emergent phenomena: a study of emergency departments in Brazil and the United States

Priscila Wachs, Tarcisio Abreu Saurin*, Angela Weber Righi, Robert Lewis Wears

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

47 Citations (Scopus)


Although the use of resilience skills (RSs) by emergency department (ED) front-line staff is ubiquitous, the nature and origin of these skills tend to be taken for granted. This study investigates the research question “where do RSs come from”? Case studies in two EDs were undertaken in order to answer the research question: one in Brazil and the other in the United States. The case studies adopted the same data collection and analysis procedures, involving interviews, questionnaires, observations, and analysis of documents. A model for describing RSs as emergent phenomena is proposed. The model indicates that RSs arise from interactions between: work constraints, hidden curriculum, gaps in standardized operating procedures, organizational support for resilience, and RSs themselves. An instantiation of the model is illustrated by a critical event identified from the American ED. The model allows the identification of leverage points for influencing the development of RSs, instead of leaving their evolution purely to chance.

Original languageEnglish
Pages (from-to)227-237
Number of pages11
JournalApplied Ergonomics
Publication statusPublished - Sept 2016
Externally publishedYes


  • Complexity
  • Emergency department
  • Resilience engineering
  • Resilience skills


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