Resident Physician, Department of Neurology, Brigham and Women's Hospital and Massachusetts General Hospital.
Chief, Division of Geriatric Psychiatry, McLean Hospital; Associate Professor of Psychiatry, Harvard Medical School.
MedEdPORTAL. 2021 Apr 30;17:11151. doi: 10.15766/mep_2374-8265.11151.
Medical students are positioned to observe, document, and explore opportunities to improve patient safety and quality in their institutions. Medical schools are introducing quality improvement (QI) knowledge and skills in the preclinical classrooms, yet few provide opportunities to apply these tools in the clinical setting.
Clerkship students participated in two 1-hour sessions, organized in groups of 12-15 students, led by faculty with QI expertise. The sessions in the module introduced core concepts in QI and patient safety, while drawing on students' own clinical experiences. Students identified a system failure they encountered in their own clinical setting/practice and analyzed contributing factors using the 5 Whys Tool. We evaluated the efficacy of the two-session module with a pre- and postsurvey of students' self-reported change in knowledge, skills, and attitudes. Surveys also assessed students' satisfaction with module content and format. Faculty perspectives were solicited by email.
In April-May 2019, 59 students at a large US medical school participated. Of students, 73% and 53% completed pre- and postsurveys, respectively. All students submitted a report of an identified systems failure and their analysis of contributing factors. Students' self-rated knowledge and skills increased significantly. Students preferred active engagement compared to passive learning. Students and faculty identified areas for future module improvement.
The educational program was well received and increased students' knowledge and confidence in core concepts of QI and safety. The module addressed the requirement for graduating students to identify safety incidents and contribute to a culture of QI.
医学生在观察、记录和探索改善医疗机构患者安全和质量的机会方面具有独特的优势。医学院校正在临床前课堂上引入质量改进（QI）知识和技能，但很少有机会将这些工具应用于临床环境。
实习学生参加了两个 1 小时的课程，课程以小组形式组织，每组 12-15 名学生，由具有 QI 专业知识的教师领导。该模块中的课程介绍了 QI 和患者安全的核心概念，同时借鉴了学生自己的临床经验。学生们确定了自己在临床环境/实践中遇到的系统故障，并使用“5 个为什么”工具分析了促成因素。我们通过学生自我报告的知识、技能和态度变化的预调查和后调查评估了两节课模块的效果。调查还评估了学生对模块内容和格式的满意度。通过电子邮件征求了教师的意见。
2019 年 4 月至 5 月，美国一所大型医学院的 59 名学生参加了该课程。其中，73%和 53%的学生分别完成了预调查和后调查。所有学生都提交了一份确定的系统故障报告和他们对促成因素的分析。学生自我评估的知识和技能显著提高。学生更喜欢主动参与，而不是被动学习。学生和教师确定了未来模块改进的领域。
教育计划受到了好评，提高了学生对 QI 和安全核心概念的知识和信心。该模块满足了毕业生识别安全事件并为 QI 文化做出贡献的要求。
