Diemer Gretchen, Jaffe Rebecca, Papanagnou Dimitrios, Zhang Xiao Chi, Zavodnick Jillian
Associate Professor, Department of Medicine, Sidney Kimmel Medical College at Thomas Jefferson University.
Vice Chair, Education of Medicine, Sidney Kimmel Medical College at Thomas Jefferson University.
MedEdPORTAL. 2019 Dec 27;15:10868. doi: 10.15766/mep_2374-8265.10868.
Although residents are on the front lines of patient care, they enter few formal patient safety reports on the adverse events and near misses they witness. Demonstrating the rationale and mechanics of reporting may improve this.
We designed and implemented an escape room patient safety simulation to incorporate active learning, gamification, and adult learning theory into intern patient safety onboarding. Interns from all sponsoring institution programs participated, identifying, mitigating, and reporting a range of patient safety hazards. Props and faculty time were the major resources required.
One hundred twenty interns participated in this simulation in June 2018. Forty-one percent reported previous training on reporting errors, and only 5% had previously entered an event report. Average confidence in ability to identify patient safety hazards improved after the simulation from 6.35 to 8.00 on a 10-point rating scale. The simulation was rated as relevant or highly relevant to practice by 96% of interns.
Several factors contribute to a low error-reporting rate among house staff. We developed a simulation modeled on popular escape room activities to increase awareness of safety hazards and ensure familiarity with the actual online reporting system our interns will use in the clinical environment.
尽管住院医师处于患者护理的第一线，但他们很少就所目睹的不良事件和险些发生的失误提交正式的患者安全报告。展示报告的基本原理和流程可能会改善这种情况。
我们设计并实施了一个密室逃脱患者安全模拟项目，将主动学习、游戏化和成人学习理论融入实习医生的患者安全入职培训中。来自所有主办机构项目的实习生参与其中，识别、缓解并报告一系列患者安全隐患。道具和教员时间是所需的主要资源。
2018年6月，120名实习生参与了此次模拟。41%的人报告曾接受过关于报告错误的培训，而此前只有5%的人提交过事件报告。在10分制评分量表上，模拟后实习生识别患者安全隐患能力的平均信心从6.35提高到了8.00。96%的实习生将该模拟评为与实践相关或高度相关。
有几个因素导致住院医生的错误报告率较低。我们开发了一个以流行的密室逃脱活动为蓝本的模拟项目，以提高对安全隐患的认识，并确保实习生熟悉他们将在临床环境中使用的实际在线报告系统。
