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美国和加拿大医学院校的患者安全教育:2006年内科实习主任调查结果

Patient safety education at U.S. and Canadian medical schools: results from the 2006 Clerkship Directors in Internal Medicine survey.

作者信息

Alper Eric, Rosenberg Eric I, O'Brien Kevin E, Fischer Melissa, Durning Steven J

机构信息

University of Massachusetts Medical School, Department of Medicine, 55 Lake Avenue North, Worcester, MA 01655, USA.

出版信息

Acad Med. 2009 Dec;84(12):1672-6. doi: 10.1097/ACM.0b013e3181bf98a4.

Abstract

PURPOSE

To describe current patient safety curricula at U.S. and Canadian medical schools and identify factors associated with adoption of these programs.

METHOD

A survey was mailed to institutional members of the Clerkship Directors in Internal Medicine at U.S. and Canadian academic medical schools in 2006. Respondents self-reported implementation of patient safety curricula and associated methods of instruction at the institution level.

RESULTS

The survey had a 76% response rate (83/110). Only 25% of institutional members reported that their schools had explicit patient safety curricula. All respondents that reported having curricula use lectures and small-group instruction, and these were more likely to occur in preclinical settings. Topics and methods of instruction included reporting adverse incidents and analysis of medical errors; improvement of physician order writing to prevent medication errors; core measures; national patient safety goals; and standardization of medical care through the use of clinical guidelines and order set templates. Although only 25% of respondents reported having explicit curricula, 72% agreed that patient safety instruction should occur during medical school.

CONCLUSIONS

Despite calls from regulatory, medical, and educational organizations to increase patient safety training of medical students, internal medicine clerkship directors report that few schools in the United States and Canada have implemented specific patient safety curricula. Most existing patient safety curricula use lecture and small-group discussion as preferred methods of instruction.

摘要

目的

描述美国和加拿大医学院当前的患者安全课程,并确定与采用这些课程相关的因素。

方法

2006年,向美国和加拿大学术医学院内科实习主任的机构成员邮寄了一份调查问卷。受访者在机构层面自行报告患者安全课程的实施情况及相关教学方法。

结果

调查回复率为76%(83/110)。只有25%的机构成员报告称他们的学校有明确的患者安全课程。所有报告有课程的受访者都使用讲座和小组教学,且这些教学更有可能在临床前阶段进行。教学主题和方法包括报告不良事件和分析医疗差错;改进医嘱书写以预防用药错误;核心指标;国家患者安全目标;以及通过使用临床指南和医嘱集模板实现医疗护理标准化。尽管只有25%的受访者报告有明确的课程,但72%的受访者同意在医学院期间应进行患者安全教学。

结论

尽管监管、医学和教育组织呼吁加强医学生的患者安全培训,但内科实习主任报告称,美国和加拿大很少有学校实施特定的患者安全课程。大多数现有的患者安全课程首选讲座和小组讨论作为教学方法。

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