Kirkman Matthew A, Sevdalis Nick, Arora Sonal, Baker Paul, Vincent Charles, Ahmed Maria
Department of Neurosurgery, Imperial College Healthcare NHS Trust, London, UK.
Health Service and Population Research Department, Centre for Implementation Science, King's College London, London, UK.
BMJ Open. 2015 May 20;5(5):e007705. doi: 10.1136/bmjopen-2015-007705.
To systematically review the latest evidence for patient safety education for physicians in training and medical students, updating, extending and improving on a previous systematic review on this topic.
A systematic review.
Embase, Ovid Medline and PsycINFO databases.
Studies including an evaluation of patient safety training interventions delivered to trainees/residents and medical students published between January 2009 and May 2014.
The review was performed using a structured data capture tool. Thematic analysis also identified factors influencing successful implementation of interventions.
We identified 26 studies reporting patient safety interventions: 11 involving students and 15 involving trainees/residents. Common educational content included a general overview of patient safety, root cause/systems-based analysis, communication and teamwork skills, and quality improvement principles and methodologies. The majority of courses were well received by learners, and improved patient safety knowledge, skills and attitudes. Moreover, some interventions were shown to result in positive behaviours, notably subsequent engagement in quality improvement projects. No studies demonstrated patient benefit. Availability of expert faculty, competing curricular/service demands and institutional culture were important factors affecting implementation.
There is an increasing trend for developing educational interventions in patient safety delivered to trainees/residents and medical students. However, significant methodological shortcomings remain and additional evidence of impact on patient outcomes is needed. While there is some evidence of enhanced efforts to promote sustainability of such interventions, further work is needed to encourage their wider adoption and spread.
系统回顾针对实习医生和医学生开展患者安全培训的最新证据，对之前关于该主题的系统综述进行更新、扩展和完善。
系统综述。
Embase、Ovid Medline和PsycINFO数据库。
纳入2009年1月至2014年5月期间发表的、对针对实习生/住院医师以及医学生的患者安全培训干预措施进行评估的研究。
使用结构化数据采集工具进行综述。主题分析还确定了影响干预措施成功实施的因素。
我们确定了26项报告患者安全干预措施的研究：11项涉及学生，15项涉及实习生/住院医师。常见的教育内容包括患者安全概述、基于根本原因/系统的分析、沟通与团队合作技能以及质量改进原则和方法。大多数课程受到学习者的好评，并提高了患者安全知识、技能和态度。此外，一些干预措施被证明能带来积极行为，尤其是随后参与质量改进项目。没有研究表明对患者有益。专家师资的可获得性、课程/服务需求竞争以及机构文化是影响实施的重要因素。
针对实习生/住院医师和医学生开展患者安全方面教育干预措施的趋势在不断增加。然而，仍存在重大方法学缺陷，需要更多关于对患者结局影响的证据。虽然有一些证据表明在加强促进此类干预措施可持续性的努力，但仍需要进一步开展工作以鼓励其更广泛地采用和推广。
