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向医学生传授医疗差错与患者安全知识:对一门必修课程的评估

Teaching medical students about medical errors and patient safety: evaluation of a required curriculum.

作者信息

Halbach Joseph L, Sullivan Laurie L

机构信息

Department of Family Medicine, New York Medical College, Munger 306, Valhalla, NY 10595, USA.

出版信息

Acad Med. 2005 Jun;80(6):600-6. doi: 10.1097/00001888-200506000-00016.

Abstract

PURPOSE

To assess the effectiveness of a brief curriculum about patient safety and medical errors with third-year medical students.

METHOD

From 2000-03, third-year medical students at New York Medical College, Valhalla, New York, were required to participate in a new curriculum on patient safety and medical errors during their family medicine clerkships. Five hundred seventy-two students participated in a four-hour curriculum that included interactive discussion, readings, a videotape session with a standardized patient, and a small-group debriefing facilitated by a family physician. Before and after participating in the curriculum, students were asked to complete questionnaires on self-awareness about patient communication and safety. Curriculum evaluations and follow-up surveys were also distributed. Responses to each statement on the before and after questionnaires were compared using the Wilcoxon signed-rank test for matched data.

RESULTS

Five hundred eleven (89%) students reported that the opportunity to present an error to a patient increased their confidence about discussing this issue with patients, and 537 (94%) students reported that they strongly agreed or agreed that the standardized patient and feedback exercise was a useful learning experience. A total of 535 before and after questionnaires were used in the analysis. A comparison of before and after questionnaire data revealed statistically significant increases in the self-reported awareness of students' strengths and weaknesses in communicating medical errors to patients (p <or= .01).

CONCLUSION

These findings suggest that awareness about patient safety and medical error can be increased and sustained through the use of an experiential curriculum, and the students rated this as a valuable experience.

摘要

目的

评估针对三年级医学生开展的关于患者安全和医疗差错的简短课程的有效性。

方法

2000年至2003年期间,纽约州瓦尔哈拉市纽约医学院的三年级医学生在家庭医学实习期间被要求参加一项关于患者安全和医疗差错的新课程。572名学生参加了一个为期四小时的课程,内容包括互动讨论、阅读材料、与标准化患者的录像课程以及由家庭医生主持的小组汇报。在参加课程前后,学生们被要求完成关于患者沟通和安全的自我认知调查问卷。还分发了课程评估和后续调查问卷。使用Wilcoxon符号秩检验对匹配数据来比较问卷前后各条陈述的回答。

结果

511名(89%)学生报告称,向患者讲述差错的机会增强了他们与患者讨论此问题的信心,537名(94%)学生报告称,他们强烈同意或同意标准化患者及反馈练习是一次有益的学习经历。分析中总共使用了535份问卷前后的数据。问卷前后数据的比较显示,学生在向患者传达医疗差错方面自我报告的优势和劣势意识有统计学意义的提高(p≤0.01)。

结论

这些发现表明,通过使用体验式课程可以提高并维持对患者安全和医疗差错的认知,并且学生们将此评为一次有价值的经历。

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