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从治愈者到伤害者:在住院医师过渡课程中让高年级医学生为患者伤害事件做好准备。

From Healer to Harmer: Preparing Senior Medical Students for Patient Harm Events in a Transition-to-Residency Course.

作者信息

Grant Campbell, Warns Sabina, Sims Lillian, Fletcher Kristen E

机构信息

Assistant Professor, Department of Urology, University of Kentucky College of Medicine.

Third-Year Medical Student, University of Kentucky College of Medicine.

出版信息

MedEdPORTAL. 2024 Dec 26;20:11473. doi: 10.15766/mep_2374-8265.11473. eCollection 2024.

Abstract

INTRODUCTION

A physician's first patient harm event oftentimes occurs during the intern year. Residents encounter and are responsible for medical errors, yet little training is offered in how to properly cope with these events. Earlier and more in-depth education about how to process patient harm events is needed.

METHODS

We developed a 110-minute workshop focused on coping strategies for patient harm events and delivered it to a cohort of fourth-year medical students during a transition-to-residency course just before graduation. The workshop emphasized interns' increasing exposure to medical errors, how to personally process them, and how to debrief near-peers in processing them.

RESULTS

A total of 190 students participated in the workshop. Our survey response rate was 88%. Students' confidence in defining second casualty after the workshop grew from eight responding or (7%) to 95 responses (87%). Comfort utilizing positive coping mechanisms improved from 14 or responses (12%) to 73 responses (67%). Confidence utilizing first responder structure grew from three or responses (3%) to 61 responses (56%). Comfort helping colleagues cope with patient harm events grew from 16 or responses (14%) to 78 responses (72%).

DISCUSSION

This workshop fills an important gap in UME by preparing senior-level students to resolve emotional conflict related to patient harm events. Our findings illustrate that a short-term intervention on this topic can impact students' confidence. We believe discussion around how patient harm events emotionally impact trainees should be expanded.

摘要

引言

医生的首次患者伤害事件往往发生在实习年期间。住院医师会遇到医疗错误并对此负责,但在如何妥善应对这些事件方面提供的培训却很少。需要更早且更深入地开展关于如何处理患者伤害事件的教育。

方法

我们开发了一个110分钟的研讨会,重点是患者伤害事件的应对策略,并在毕业前的住院医师过渡课程期间将其传授给一群四年级医学生。该研讨会强调实习医师越来越多地接触到医疗错误、如何个人处理这些错误以及如何在处理这些错误时与同龄人进行汇报交流。

结果

共有190名学生参加了该研讨会。我们的调查回复率为88%。研讨会后,学生在定义次生伤亡方面的信心从8人回答(7%)增加到95人回答(87%)。使用积极应对机制的舒适度从14人回答(12%)提高到73人回答(67%)。使用第一响应者结构的信心从3人回答(3%)增加到61人回答(56%)。帮助同事应对患者伤害事件的舒适度从16人回答(14%)提高到78人回答(72%)。

讨论

该研讨会通过让高年级学生准备好解决与患者伤害事件相关的情感冲突,填补了本科医学教育中的一个重要空白。我们的研究结果表明,关于这个主题的短期干预可以影响学生的信心。我们认为,围绕患者伤害事件如何在情感上影响受训人员的讨论应该扩大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65ab/11669734/8e7dd2ef3b0f/mep_2374-8265.11473-g001.jpg

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