Role of medical students in preventing patient harm and enhancing patient safety

Abstract Background Simulated participants (SPs) play an important role in simulated assessments of clinical encounters between medical students and patients, most notably in objective structured clinical examinations (OSCEs). SP contributions to OSCEs are invaluable, taking the role of a patient or carer. While SPs in some settings/contexts may rate students, their role has been problematized in the literature for their lack of agency within a standardised format of OSCEs that promotes reliability, objectivity and accountability. In this study, we explored SP experiences for tensions that result from simulated assessments and their potential implications for education. Methods Semi-structured interviews were conducted with seven SPs who were also tasked with providing a global mark for students. They were purposively selected to include women and men of different ages, occupation, education and experience as an SP. The interviews were analysed using a critical thematic analysis using a phenomenological approach. Results SP experiences directly addressed tensions and contradictions around OSCEs. SP participants described their experiences under four themes: industrialising, reducing, performativity and patient safety. OSCEs were compared to an industrial process that promoted efficiency but which bore no resemblance to real-life doctor-patient encounters. They were perceived to have a power and agency that reduced SPs to verbalising scripts to ensure that students were exposed to a standardised simulated experience that also underlined the performative role of SPs as props. These performative and reductionist experiences extended to students, for whom the mark sheet acted as a checklist, promoting standardised responses that lacked genuineness. All of this created a tension for SPs in promoting patient safety by ensuring that those medical students who passed were clinically competent. Conclusions OSCEs often form part of high-stakes exams. As such, they are governed by processes of industrialisation, accountability and standardisation. OSCEs possess a power and agency that can have unintended negative consequences. These include ‘conditioning’ students to adopt behaviours that are not suited to real-life clinical encounters and are not person-centred.

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The effect of the COVID-19 pandemic on the patient safety attitude of medical students

Korean Journal of Medical Education ◽

10.3946/kjme.2021.202 ◽

2021 ◽

Vol 33 (3) ◽

pp. 227-232

Author(s):

Jisoo Lee ◽

Kyung Hye Park

Keyword(s):

Patient Safety ◽

Medical Students ◽

Medical Errors ◽

Traditional Learning ◽

Face To Face ◽

Poor Understanding ◽

Before And After ◽

Face To Face Learning ◽

Safety Attitude

Purpose: This study aimed to examine the differences in scores of the Attitude to Patient Safety Questionnaire (APSQ) by medical students before and after the outbreak of COVID-19.Methods: In total, 97 and 118 medical students completed patient safety courses at Yonsei University Wonju College of Medicine in 2019 and 2020, respectively. In 2019, the course was conducted using traditional learning in the classroom, whereas, in 2020, most of the classes were conducted using non-face-to-face learning methods.Results: In 2019 and 2020, 49 and 53 students responded to the APSQ. Only one item “Patients are not really aware of how safe their care is” had a lower score in 2020 than in 2019.Conclusion: Although the total APSQ score did not differ between 2019 and 2020, the students in 2020 might have a poor understanding of the role of patients in medical errors.

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The Role of Nurses in the Implementation of Patient Safety and Protection of Patient Rights at the Rahayu Yakkum Purwodadi Hospital

SOEPRA ◽

10.24167/shk.v5i2.1751 ◽

2020 ◽

Vol 5 (2) ◽

pp. 254

Author(s):

Christina Nur Widayati ◽

Endang Wahyati Yustina ◽

Hadi Sulistyanto

Keyword(s):

Health Care ◽

Patient Safety ◽

Codes Of Conduct ◽

Rights Protection ◽

Patient’S Rights ◽

Nurses Role ◽

The Republic ◽

The Right ◽

Service Standards

Patient Safety was the right of a patient who was receiving health care. A nurse was one of the health professionals in a hospital having a very important role in realizing Patient Safety. In realizing Patient Safety Panti Rahayu Yakkum Hospital of Purwodadi had involved the role of the nurses. In carrying out their role the nurses could support the protection of the patient’s rights. The nurses performed health care by conducting six Patient Safety goals that were based on professional standards, service standards and codes of conduct so that the Patient Safety would be realized.This research applied a socio-legal approach to having analytical-descriptive specifications. The data used were primary and secondary those were gathered by field and literature studies. The field study was conducted by having interviews to, among others, the Director of Panti Rahayu Yakkum Hospital of Purwodadi, Head of Room and Chairman of Patient Safety Committee, nurses and patients. The data were then qualitatively analyzed.The arrangement of nurses’ role in implementing Patient Safety and the patient’s rights protection was based on the Constitution of the Republic of Indonesia of 1945, Health Act, Hospital Act, Labor Act, and Nursing Act. These bases made the hospital obliged to implement Patient Safety. The regulations leading the hospital to provide Patient Safety were Health Minister’s Regulation Nr. 11 of 2017 on Patient Safety, Statute of Panti Rahayu Yakkum Hospital of Purwodadi (Hospital ByLaws), Internal Nursing Staff ByLaws. In implementing Patient Safety Panti Rahayu Yakkum Hospital of Purwodadi had established a committee of Patient Safety team consisting of the nurses that would implement six targets of Patient Safety. Actually, the Patient Safety implementation had been accomplished but it had not been optimally done because of several factors, namely juridical, social and technical factors. The supporting factors in influencing the implementation were, among others, the establishment of the Patient Safety team that had been well socialized whereas the inhibiting factors were limitedness of time and funds to train the nurses besides the operational procedure standard (OPS) that was still less understood. Lack of learning motivation among the nurses also appeared as an inhibiting factor in understanding Patient Safety implementation.

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Clinical Cybersecurity Training Through Novel High Fidelity Simulations (Preprint)

10.2196/preprints.9853 ◽

2018 ◽

Author(s):

Christian Dameff ◽

Jordan Selzer ◽

Jonathan Fisher ◽

James Killeen ◽

Jeffrey Tully

Keyword(s):

Patient Safety ◽

Patient Care ◽

Medical Devices ◽

Healthcare Systems ◽

High Fidelity ◽

Protected Health Information ◽

Patient Harm ◽

Security Vulnerabilities ◽

Clinical Simulations ◽

Medical Infrastructure

BACKGROUND Cybersecurity risks in healthcare systems have traditionally been measured in data breaches of protected health information but compromised medical devices and critical medical infrastructure raises questions about the risks of disrupted patient care. The increasing prevalence of these connected medical devices and systems implies that these risks are growing. OBJECTIVE This paper details the development and execution of three novel high fidelity clinical simulations designed to teach clinicians to recognize, treat, and prevent patient harm from vulnerable medical devices. METHODS Clinical simulations were developed which incorporated patient care scenarios with hacked medical devices based on previously researched security vulnerabilities. RESULTS Clinician participants universally failed to recognize the etiology of their patient’s pathology as being the result of a compromised device. CONCLUSIONS Simulation can be a useful tool in educating clinicians in this new, critically important patient safety space.

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Patient safety and the role of the Helsinki Declaration on Patient Safety in Anaesthesiology

European Journal of Anaesthesiology ◽

10.1097/eja.0000000000001043 ◽

2019 ◽

Vol 36 (12) ◽

pp. 946-954 ◽

Cited By ~ 4

Author(s):

Henry H.L. Wu ◽

Sharon R. Lewis ◽

Mirka Čikkelová ◽

Johannes Wacker ◽

Andrew F. Smith

Keyword(s):

Patient Safety ◽

Helsinki Declaration

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Incorporating patient safety into early undergraduate medical education: teaching medical students to perform surgical time outs during anatomy

BMJ Open Quality ◽

10.1136/bmjoq-2020-001229 ◽

2021 ◽

Vol 10 (1) ◽

pp. e001229

Author(s):

Abdul-Rahman M Suleiman ◽

Daniel Amarasinghe ◽

Priya Kathuria ◽

Jacob Vandel ◽

Jordan Holloway ◽

...

Keyword(s):

Medical Education ◽

Patient Safety ◽

Medical Students ◽

Gross Anatomy ◽

First Year ◽

Surgical Time ◽

Surgical Safety ◽

Wayne State University ◽

Time Out ◽

Surgical Errors

ObjectivesTo introduce surgical safety checklists and time outs to future physicians through early incorporation of time outs in the first year gross anatomy course.SettingThe Wayne State University School of Medicine Anatomy Lab.ParticipantsApproximately 300 first year medical students per year participated in the intervention.InterventionsAn educational presentation on medical errors focusing on surgical errors was developed. Students in 2017–2018 viewed the presentation and completed two time outs, one with the first anatomy dissection and a second with the last dissection. Preintervention and postintervention surveys were completed and results compared. Students completed a second postintervention survey after the second time out. Students in 2018–2019 were asked to complete the time outs before every dissection. Time out procedure sheets were collected to determine completion rates. The intervention was further modified for academic year 2019–2020 and time out sheets were again collected.Outcome measuresFour domains of learning were surveyed: (1) major components and goals/limitations of universal protocol, (2) medical error lexicon, (3) components of a time out, and (4) confidence in completing time out checklists.ResultsPostintervention surveys demonstrated significant improvement in each domain. Students found time outs easy to complete and developed confidence in performing time outs. Following a successful pilot, time outs were incorporated into every dissection. Students continued to perform this procedure despite absence of adverse consequences for not doing so.ConclusionStudents found the time outs easy to complete and developed the confidence and ability to perform a surgical time out early in their medical education. The new skills, knowledge and attitudes that these medical students have developed will hopefully improve the care they provide to patients, thereby advancing the practice of quality improvement and patient safety in the clinical setting.

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Enhancing Patient Safety by Reducing Healthcare-Associated Infections: The Role of Discovery and Dissemination

Infection Control and Hospital Epidemiology ◽

10.1086/650198 ◽

2010 ◽

Vol 31 (2) ◽

pp. 118-123 ◽

Cited By ~ 32

Author(s):

Keyword(s):

Patient Safety ◽

Healthcare System ◽

Research Agenda ◽

Position Paper ◽

Public Confidence ◽

Healthcare Associated Infections ◽

Science Base ◽

Healthcare Associated ◽

National Approach

Healthcare-associated infections (HAIs) take a major human toll on society and reduce public confidence in the healthcare system. The current convergence of scientific, public, and legislative interest in reducing rates of HAI can provide the necessary momentum to address and answer important questions in HAI research. This position paper outlines priorities for a national approach to HAIs: scrutinizing the science base, developing a prioritized research agenda, conducting studies that address the questions that have been identified, creating and deploying guidelines that are based on the outcomes of these studies, and then initiating new studies that assess the efficacy of the interventions.

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