Aboumrad Maya, Neily Julia, Watts Bradley V
National Center for Patient Safety, White River Junction, VT, USA.
White River Junction Veterans Affairs Medical Center, White River Junction, VT, USA.
J Med Educ Curric Dev. 2019 Dec 18;6:2382120519894270. doi: 10.1177/2382120519894270. eCollection 2019 Jan-Dec.
Clinicians are key drivers for improving health care quality and safety. However, some may lack experience in quality improvement and patient safety (QI/PS) methodologies, including root cause analysis (RCA).
The Department of Veterans Affairs (VA) sought to develop a simulation approach to teach clinicians from the VA's Chief Resident in Quality and Safety program about RCA. We report the use of experiential learning to teach RCA, and clinicians' preparedness to conduct and teach RCA post-training. We provide curriculum details and materials to be adapted for widespread use.
The course was designed to meet the learning objectives through simulation. We developed course materials, including presentations, a role-playing case, and an elaborate RCA case. Learning objectives included (1) basic structure of RCA, (2) process flow diagramming, (3) collecting information for RCA, (4) cause and effect diagramming, and (5) identifying actions and outcomes. We administered a voluntary, web-based survey in November 2016 to participants (N = 114) post-training to assess their competency with RCA.
A total of 93 individuals completed the survey of the 114 invited to participate, culminating an 82% response rate. Nearly all respondents (99%, N = 92) reported feeling at least moderately to extremely prepared to conduct and teach RCA post-training. Most respondents reported feeling very to extremely prepared to conduct and teach RCA (77%, N = 72).
Experiential learning involving simulations may be effective to improve clinicians' competency in QI/PS practices, including RCA. Further research is warranted to understand how the training affects clinicians' capacity to participate in real RCA teams post-training, as well as applicability to other disciplines and interdisciplinary teams.
临床医生是提高医疗质量和安全的关键推动因素。然而，有些人可能缺乏质量改进和患者安全（QI/PS）方法的经验，包括根本原因分析（RCA）。
退伍军人事务部（VA）试图开发一种模拟方法，向VA质量与安全首席住院医师项目的临床医生传授RCA。我们报告了使用体验式学习来教授RCA，以及临床医生在培训后进行和教授RCA的准备情况。我们提供课程细节和材料以供广泛使用。
该课程旨在通过模拟实现学习目标。我们开发了课程材料，包括演示文稿、角色扮演案例和详细的RCA案例。学习目标包括：（1）RCA的基本结构；（2）流程流程图绘制；（3）为RCA收集信息；（4）因果关系图绘制；（5）确定行动和结果。2016年11月，我们对参与者（N = 114）进行了一项基于网络的自愿调查，以评估他们在培训后进行RCA的能力。
在受邀参加的114人中，共有93人完成了调查，最终回复率为82%。几乎所有受访者（99%，N = 92）表示，在培训后至少有中等至极高的准备程度来进行和教授RCA。大多数受访者表示有非常高至极高的准备程度来进行和教授RCA（77%，N = 72）。
涉及模拟的体验式学习可能有效地提高临床医生在QI/PS实践（包括RCA）方面的能力。有必要进一步研究，以了解该培训如何影响临床医生在培训后参与实际RCA团队的能力，以及对其他学科和跨学科团队的适用性。
