Madigosky Wendy S, Headrick Linda A, Nelson Kathryn, Cox Karen R, Anderson Timothy
Office of Predoctoral Education, Department of Family Medicine, University of Colorado at Denver and Health Sciences Center, 4200 East Ninth Avenue, Box B157, Denver, CO 80262, USA.
Acad Med. 2006 Jan;81(1):94-101. doi: 10.1097/00001888-200601000-00022.
To study the effects of a patient safety and medical fallibility curriculum on second-year medical students at the University of Missouri-Columbia School of Medicine in 2003-2004.
Students completed a knowledge, skills, and attitudes questionnaire before the curriculum, after the final learning experience, and one year later. A 95% confidence interval (CI) for paired differences assessed change over time. At one year, students also responded to items about their use of the curriculum, error reporting, and disclosure experiences.
Fifty three of 92 students (55%) completed the questionnaire at all three assessment points. Students' eight items and the calculated knowledge score improved after the curriculum but only seven of these improvements were sustained one year. Responses to seven items did not change and five changed in an undesired direction after the curriculum and/or after one year. Seventy two students completed the self-reported behavior questions at one year. More than half reported using what they learned in the curriculum. Although 76% of students reported observing an error, 71% of these disclosed an error to their peers, 56% to a resident, and 46% to faculty. Only 7% reported an error using our electronic error reporting system.
The curriculum led to changes in second-year medical students' knowledge, skills, and attitudes, but not all of the changes were sustained at one year, were in the desired direction, or were supported by their self-reported behaviors. The extent to which other informal or hidden curriculum experiences reversed the gains and affected the changes at one year is unknown.
研究2003 - 2004年在密苏里大学哥伦比亚分校医学院开展的患者安全与医疗差错课程对二年级医学生的影响。
学生们在课程开始前、最终学习体验结束后以及一年后完成了一份关于知识、技能和态度的问卷。配对差异的95%置信区间（CI）用于评估随时间的变化。在一年时，学生们还回答了关于他们对课程的使用、差错报告和信息披露经历的问题。
92名学生中有53名（55%）在所有三个评估点都完成了问卷。课程结束后，学生们在八项内容及计算得出的知识得分上有所提高，但其中只有七项提高在一年后仍得以保持。对七项内容的回答没有变化，五项在课程结束后和/或一年后朝着不理想的方向发生了变化。72名学生在一年时完成了自我报告行为问题。超过一半的学生报告称运用了他们在课程中学到的知识。尽管76%的学生报告观察到了差错，但其中71%向同伴披露了差错，56%向住院医师披露了差错，46%向教员披露了差错。只有7%的学生通过我们的电子差错报告系统报告了差错。
该课程使二年级医学生的知识、技能和态度发生了变化，但并非所有变化在一年后都得以保持，也并非都朝着理想方向发展，或者得到他们自我报告行为的支持。其他非正式或隐性课程体验在多大程度上抵消了这些收获并影响了一年后的变化尚不清楚。
