Hall L W, Scott S D, Cox K R, Gosbee J W, Boshard B J, Moylan K, Dellsperger K C
School of Medicine, University of Missouri-Columbia, Room 202A, Columbia, MO 65212, USA.
Qual Saf Health Care. 2010 Feb;19(1):3-8. doi: 10.1136/qshc.2008.031781.
In an effort to improve patient safety attitudes and skills among third-year medical students, two patient safety training sessions were added to their curriculum, complementing a previously implemented second-year curriculum on quality improvement, patient safety and teamwork.
Safety attitudes and skills were assessed before and after students completed the medicine clerkship training and were compared with historical controls. Students identified and reported on observed safety events, with their reports matched to event type and harm score with contemporaneous safety reports from University of Missouri's Patient Safety Network (PSN). Comparisons were assessed by five internal safety experts using criteria for report submission "worthiness", blame tone, target of blame and presence/strength of proposed solutions.
Students completing the third-year safety booster conferences expressed statistically higher comfort levels with identifying the cause of an error than did the student control group (p<0.05). Medical students proposed safety interventions that were more robust than those suggested by event reporters regarding similar events within our health system (p<0.0001). The worthiness and blame tone of medical student reports were not statistically different than event reports in PSN.
Completion of two 1-h patient safety booster conferences in the third year of medical school led to increased student comfort in safety event analysis. Students documented stronger resolution robustness scores, suggesting similar training should be offered to PSN reporters. Medical students represent an underutilised resource for identifying and proposing solutions for patient safety issues.
为提高三年级医学生的患者安全态度和技能,在其课程中增加了两次患者安全培训课程,以补充之前在二年级实施的关于质量改进、患者安全和团队合作的课程。
在学生完成内科实习培训前后对安全态度和技能进行评估,并与历史对照组进行比较。学生识别并报告观察到的安全事件,他们的报告与事件类型和伤害评分相匹配,并与密苏里大学患者安全网络(PSN)同期的安全报告进行对比。由五位内部安全专家根据报告提交的“价值”、指责语气、指责对象以及所提出解决方案的存在/力度标准对比较结果进行评估。
完成三年级安全强化会议的学生在识别错误原因方面的舒适度在统计学上高于学生对照组(p<0.05)。医学生提出的安全干预措施比我们医疗系统中事件报告者针对类似事件提出的措施更有力(p<0.0001)。医学生报告的价值和指责语气与PSN中的事件报告在统计学上没有差异。
在医学院三年级完成两次1小时的患者安全强化会议可提高学生在安全事件分析中的舒适度。学生记录的解决力度得分更高,这表明应向PSN报告者提供类似培训。医学生是识别和提出患者安全问题解决方案的未充分利用的资源。