McCoy Lise, Lewis Joy H, Simon Harvey, Sackett Denise, Dajani Tala, Morgan Christine, Hunt Aaron
Department of Academic Affairs, College of Osteopathic Medicine, New York Institute of Technology, Jonesboro, AR, USA.
Department of Public Health, School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa, AZ, USA.
J Med Educ Curric Dev. 2020 Jun 28;7:2382120520935469. doi: 10.1177/2382120520935469. eCollection 2020 Jan-Dec.
Preventable medical errors represent a leading cause of death in the United States. Effective undergraduate medical education (UME) strategies are needed to train medical students in error prevention, early identification of potential errors, and proactive communication. To address this need, a team of faculty from A.T. Still University's School of Osteopathic Medicine in Arizona developed four digital patient safety case scenarios for second-year medical students. These scenarios were designed to integrate interprofessional collaboration and patient safety principles, increase student ability to identify potential errors, and promote proactive communication skills.
Faculty used Qualtrics to create four digital case scenarios on patient safety covering the following domains: communicating about potential drug-to-drug interactions; effective handoffs; human factors errors, such as fatigue, illness, and stress; and conflicts with supervising resident. In fall 2018, 97 second-year medical students completed the entire safety module in dyad or triad teams. As they worked through each case study, student teams completed 11 assessment questions with instant feedback, and participated in short case debrief discussions. Next, each individual student took a 12-question post-test to assess learning. Descriptive statistics were reviewed for the assessment questions, and case critical thinking discussion answers were reviewed to evaluate student comprehension.
The mean score for the module was 95.5% (SD= 6.36%, range = 75%-100%). Seventy-eight students completed the post-test, which had a mean score of 96.5% (SD = 6.51%, range = 66.7%-100%). Student written responses to the four case critical thinking discussion prompts indicated a high level of comprehension.
Our results demonstrated that digital case studies can provide an innovative mechanism to introduce key patient safety concepts and experiential practice of interprofessional communication in early UME. Our design and implementation of these engaging interprofessional patient safety training modules provided an opportunity for students to learn key communication and safety concepts in small teams. This training method was cost-effective and could be replicated in other online learning or blended learning environments for a wide range of health professions.
可预防的医疗差错是美国主要的死亡原因之一。需要有效的本科医学教育(UME)策略来培训医学生预防差错、早期识别潜在差错以及进行积极沟通。为满足这一需求,亚利桑那州A.T. 斯蒂尔大学整骨医学院的一组教师为二年级医学生开发了四个数字患者安全案例场景。这些场景旨在整合跨专业协作和患者安全原则,提高学生识别潜在差错的能力,并促进积极沟通技巧。
教师使用Qualtrics创建了四个关于患者安全的数字案例场景,涵盖以下领域:关于潜在药物相互作用的沟通;有效的交接班;人为因素导致的差错,如疲劳、疾病和压力;以及与住院医师上级的冲突。2018年秋季,97名二年级医学生以两人或三人小组的形式完成了整个安全模块。在他们完成每个案例研究时,学生小组完成了11个评估问题并获得即时反馈,并参与简短的案例总结讨论。接下来,每个学生单独进行了一次12道题的后测以评估学习情况。对评估问题进行了描述性统计分析,并对案例批判性思维讨论答案进行了审查以评估学生的理解情况。
该模块的平均成绩为95.5%(标准差=6.36%,范围=75%-100%)。78名学生完成了后测,后测平均成绩为96.5%(标准差=6.51%,范围=66.7%-100%)。学生对四个案例批判性思维讨论提示的书面回答表明他们有较高的理解水平。
我们的结果表明,数字案例研究可以提供一种创新机制,在早期本科医学教育中引入关键的患者安全概念和跨专业沟通的实践经验。我们对这些引人入胜的跨专业患者安全培训模块的设计和实施为学生提供了在小团队中学习关键沟通和安全概念的机会。这种培训方法具有成本效益,并且可以在其他在线学习或混合学习环境中复制,适用于广泛的健康专业。