Department of Medicine, Rutgers University Robert Wood Johnson Medical School, Director of Internal Medicine Bootcamp Program,, 125 Paterson St., Suite 2300, New Brunswick, NJ, 08901, USA.
Department of Psychiatry, Rutgers University Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
BMC Med Educ. 2023 Apr 12;23(1):235. doi: 10.1186/s12909-023-04220-5.
Identifying systems failures and contributing to a safety culture is the Association of American Colleges (AAMC's) thirteenth Entrustable Professional Activity (EPA). While most curricula teach Patient Safety (PS) and Quality Improvement (QI) principles, student participation in live QI/PS activities remains limited. This workshop enabled late Clerkship phase students to apply these Health Systems Science (HSS) principles to real adverse patient event cases through team-based simulation.This 3-h capstone included both a didactic review of QI, PS, and TeamSTEPPS® tools and an experiential component where student-led interactive small group discussions were augmented by resident and faculty preceptors. Collaboratively, students composed an adverse patient event report, conducted a Root Cause Analysis (RCA) during role-play, and proposed error prevention ideas after identifying systems problems. In April 2020, the in-person workshop became fully virtual due to the COVID-19 pandemic.A statistically significant increase in ability to identify Serious Safety Events, Escalation Chain of Command, and define a Plan-Do-Study-Act (PDSA) cycle was observed. Comfort with RCA increased from 48 to 87% and comfort with TeamSTEPPS® principles increased from 68% to 85.5%This novel capstone provided students with the tools to synthesize HSS concepts through problem-solving processes and recognize EPA 13's importance. Their increased capability to identify appropriate chain of command, escalate concerns, and recognize serious adverse patient events also has training and practice readiness implications.
识别系统故障并促进安全文化是美国学院协会(AAMC)的第十三个可委托专业活动(EPA)。虽然大多数课程都教授患者安全(PS)和质量改进(QI)原则,但学生参与现场 QI/PS 活动仍然有限。该研讨会使实习后期的学生能够通过基于团队的模拟将这些卫生系统科学(HSS)原则应用于真实的不良患者事件案例。这个 3 小时的顶点课程包括 QI、PS 和 TeamSTEPPS®工具的教学回顾,以及体验式部分,学生主导的互动小组讨论由住院医师和教师导师补充。学生们共同撰写了一份不良患者事件报告,在角色扮演中进行了根本原因分析(RCA),并在确定系统问题后提出了防止错误的想法。2020 年 4 月,由于 COVID-19 大流行,面对面研讨会完全转为虚拟形式。观察到学生识别严重安全事件、升级指挥链和定义计划-执行-研究-行动(PDSA)循环的能力有了显著提高。对 RCA 的舒适度从 48%提高到 87%,对 TeamSTEPPS®原则的舒适度从 68%提高到 85.5%。这个新颖的顶点课程为学生提供了通过解决问题的过程综合 HSS 概念的工具,并认识到 EPA 13 的重要性。他们能够更准确地识别适当的指挥链、提出关注问题以及识别严重的不良患者事件,这也对培训和实践准备具有重要意义。