scholarly journals Analysis of the Interprofessional Clinical Learning Environment for Quality Improvement and Patient Safety From Perspectives of Interprofessional Teams

2021 ◽  
Vol 13 (6) ◽  
pp. 822-832
Author(s):  
Mike K.W. Cheng ◽  
Sally Collins ◽  
Robert B. Baron ◽  
Christy K. Boscardin
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Learning Environment ◽  
Learning Opportunities ◽  
Clinical Learning ◽  
Clinical Learning Environment ◽  
Factors Affecting ◽  
Educational Culture ◽  
Current State ◽  
Template Analysis

ABSTRACT Background In 2018 the Clinical Learning Environment Review (CLER) Program reported that quality improvement and patient safety (QIPS) programs in graduate medical education (GME) were largely unsuccessful in their efforts to transfer QI knowledge and substantive interprofessional QIPS experiences to residents, and CLER 2.0 called for improvement. However, little is known about how to improve the interprofessional clinical learning environment (IP-CLE) for QIPS in GME. Objective To determine the current state of the IP-CLE for QIPS at our institution with a focus on factors affecting the IP-CLE and resident integration into interprofessional QIPS teams. Methods We interviewed an interprofessional group of residents, faculty, and staff of key units engaged in IP QIPS activities. We performed thematic analysis through general inductive approach using template analysis methods on transcripts. Results Twenty individuals from 6 units participated. Participants defined learning on interprofessional QIPS teams as learning from and about each other's roles through collaboration for improvement, which occurs naturally when patients are the focus, or experiential teamwork within QIPS projects. Resident integration into these teams had various benefits (learning about other professions, effective project dissemination), barriers (difficult rotations or program structure, inappropriate assumptions), and facilitators (institutional support structures, promotion of QIPS culture, patient adverse events). There were various benefits (strengthened relationships, lowered bar for further collaboration), barriers (limited time, poor communication), and facilitators (structured meetings, educational culture) to a positive IP-CLE for QIPS. Conclusions Cultural factors prominently affected the IP-CLE and patient unforeseen events were valuable triggers for IP QIPS learning opportunities.

Using Patient Safety Reporting Systems to Understand the Clinical Learning Environment: A Content Analysis

2018 ◽  
Vol 75 (6) ◽  
pp. e168-e177 ◽  
Author(s):  
Morgan M. Sellers ◽  
Ian Berger ◽  
Jennifer S. Myers ◽  
Judy A. Shea ◽  
Jon B. Morris ◽  
...  
Keyword(s):  
Patient Safety ◽  
Content Analysis ◽  
Learning Environment ◽  
Clinical Learning ◽  
Clinical Learning Environment ◽  
Safety Reporting ◽  
Reporting Systems

scholarly journals Evaluating the Clinical Learning Environment: Resident and Fellow Perceptions of Patient Safety Culture

2015 ◽  
Vol 7 (1) ◽  
pp. 109-112 ◽  
Author(s):  
Gregory M. Bump ◽  
Jaclyn Calabria ◽  
Gabriella Gosman ◽  
Catherine Eckart ◽  
David G. Metro ◽  
...  
Keyword(s):  
Medical Education ◽  
Patient Safety ◽  
Learning Environment ◽  
Health System ◽  
Graduate Medical Education ◽  
Safety Culture ◽  
Patient Safety Culture ◽  
Clinical Learning ◽  
Clinical Learning Environment ◽  
National Norms

Abstract Background The Accreditation Council for Graduate Medical Education has begun to evaluate teaching institutions' learning environments with Clinical Learning Environment Review visits, including trainee involvement in institutions' patient safety and quality improvement efforts. Objective We sought to address the dearth of metrics that assess trainee patient safety perceptions of the clinical environment. Methods Using the Hospital Survey on Patient Safety Culture (HSOPSC), we measured resident and fellow perceptions of patient safety culture in 50 graduate medical education programs at 10 hospitals within an integrated health system. As institution-specific physician scores were not available, resident and fellow scores on the HSOPSC were compared with national data from 29 162 practicing providers at 543 hospitals. Results Of the 1337 residents and fellows surveyed, 955 (71.4%) responded. Compared with national practicing providers, trainees had lower perceptions of patient safety culture in 6 of 12 domains, including teamwork within units, organizational learning, management support for patient safety, overall perceptions of patient safety, feedback and communication about error, and communication openness. Higher perceptions were observed for manager/supervisor actions promoting patient safety and for staffing. Perceptions equaled national norms in 4 domains. Perceptions of patient safety culture did not improve with advancing postgraduate year. Conclusions Trainees in a large integrated health system have variable perceptions of patient safety culture, as compared with national norms for some practicing providers. Administration of the HSOPSC was feasible and acceptable to trainees, and may be used to track perceptions over time.

Evaluation of the Clinical Learning Experience of Nursing Students: a Cross-Sectional Descriptive Study

2018 ◽  
Vol 15 (1) ◽  
Author(s):  
Elena Gurková ◽  
Katarína Žiaková
Keyword(s):  
Nursing Students ◽  
Learning Environment ◽  
Learning Experience ◽  
Descriptive Study ◽  
Clinical Learning ◽  
Clinical Environment ◽  
Clinical Learning Environment ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Eastern European Countries

AbstractThe purpose of the cross-sectional descriptive study was to explore and compare the students’ experiences of the clinical environment and supervision in Slovakia. Students’ clinical learning experience were measured by the valid and reliable clinical learning instrument. A higher frequency of successful supervisory experience was found in the universities which provided accredited mentor preparation programmes or courses and individualised supervisory approaches. Frequency of supervision meetings, the occupational title of a supervisor and mainly the supervision model have an association with students ‘perceptions of different domains of clinical learning environment. The duration of the placement was not related to students’ experience and perceptions of the learning environment. Slovak students reported higher score regarding the quality of nursing care or ward culture than in the supervisory relationships between students, clinical and school staff. Further studies in this field, extended to different Eastern European countries and clinical settings, may help us to understand factors affecting workplace training.

scholarly journals Development, Testing, and Implementation of the ACGME Clinical Learning Environment Review (CLER) Program

2012 ◽  
Vol 4 (3) ◽  
pp. 396-398 ◽  
Author(s):  
Kevin B. Weiss ◽  
Robin Wagner ◽  
Thomas J. Nasca
Keyword(s):  
Patient Safety ◽  
Quality Of Care ◽  
Learning Environment ◽  
Care Transitions ◽  
Teaching Hospitals ◽  
Clinical Learning ◽  
Clinical Learning Environment ◽  
The Status ◽  
Accredited Institutions

Abstract Since the release of the Institute of Medicine's report on resident hours and patient safety, there have been calls for enhanced institutional oversight of duty hour limits and of efforts to enhance the quality and safety of care in teaching hospitals. The ACGME has established the Clinical Learning Environment Review (CLER) program as a key component of the Next Accreditation System with the aim to promote safety and quality of care by focusing on 6 areas important to the safety and quality of care in teaching hospitals and the care residents will provide in a lifetime of practice after completion of training. The 6 areas encompass engagement of residents in patient safety, quality improvement and care transitions, promoting appropriate resident supervision, duty hour oversight and fatigue management, and enhancing professionalism. Over the coming 18 months the ACGME will develop, test, and fully implement this new program by conducting visits to the nearly 400 clinical sites of sponsoring institutions with two or more specialty or subspecialty programs. These site visits will provide an understanding of how the learning environment for the 116 000 current residents and fellows addresses the 6 areas important to safety and quality of care, and will generate baseline data on the status of these activities in accredited institutions. We expect that over time the CLER program will serve as a new source of formative feedback for teaching institutions, and generate national data that will guide performance improvement for United States graduate medical education.

scholarly journals Psychometric Testing of the Student Evaluation of Clinical Educational Environment Inventory in Greek Nursing Students

2016 ◽  
Vol 9 (5) ◽  
pp. 241
Author(s):  
Ourania Govina ◽  
Eugenia Vlachou ◽  
Maria Lavdaniti ◽  
Ioannis Kalemikerakis ◽  
Nikoletta Margari ◽  
...  
Keyword(s):  
Nursing Students ◽  
Learning Environment ◽  
Student Perceptions ◽  
Assessment Tool ◽  
Student Evaluation ◽  
Learning Opportunities ◽  
Educational Environment ◽  
Clinical Learning ◽  
Clinical Learning Environment ◽  
Greek Translation

<p><strong>INTRODUCTION:</strong> The need for translation and validation of an assessment tool regarding the<em> </em>Clinical Learning Environment of nursing students in Greece is imperative, given that inappropriate research tools are frequently used. <strong>Τhe aim</strong> of this study was to validate and psychometrically test the Greek translation of the Student Evaluation of Clinical Educational Environment (SECEE) Version 3 Inventory, with a sample of senior nursing students during their clinical practice.</p><p><strong>METHODS:</strong><em> </em>Following a formal “forward-backward” method to translate the original SECEE into Greek, the scale was administered to 130 senior students. They also completed the Clinical Learning Environment and Supervision (CLES) Scale. Validity and reliability analyses were performed.</p><p><strong>RESULTS:</strong><em> </em>Cronbach’s alpha coefficient for the SECEE subscales score was 0.89 for Instructor Facilitation of Learning (IFL), 0.84 for Learning Opportunities (LO) and 0.84 for Preceptor Facilitation of Learning (PFL). Test-retest reliability analysis in a subgroup of students (n=40) revealed good short term stability over a two week interval. Confirmatory factor analysis confirmed the three factor subscales for the Greek translation, as in the original scale. Construct validity was supported through the scale’s moderate correlation with CLES subscales, ranged from 0.163 to 0.317 for IFL, from 0.387 to 0.445 for LO and from 0.443 to 0.537 for PFL.</p><p><strong>CONCLUSIONS</strong><strong>: </strong>The Greek version of the SECEE is a psychometrically sound instrument that can be usefully implemented into clinical education to identify appropriate clinical sites and provide information about student perceptions regarding the adequacy of learning opportunities. <strong></strong></p>

scholarly journals The Challenges of Nursing Students in the Clinical Learning Environment: A Qualitative Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Nahid Jamshidi ◽  
Zahra Molazem ◽  
Farkhondeh Sharif ◽  
Camellia Torabizadeh ◽  
Majid Najafi Kalyani
Keyword(s):  
Nursing Education ◽  
Nursing Students ◽  
Qualitative Study ◽  
Learning Environment ◽  
Psychological Needs ◽  
Emotional Reactions ◽  
Clinical Learning ◽  
Clinical Learning Environment ◽  
Factors Affecting ◽  
Teaching Learning

Background/Aim. Clinical learning is a main part of nursing education. Students’ exposure to clinical learning environment is one of the most important factors affecting the teaching-learning process in clinical settings. Identifying challenges of nursing students in the clinical learning environment could improve training and enhance the quality of its planning and promotion of the students. We aimed to explore Iranian nursing students’ challenges in the clinical learning environment.Materials and Methods. This is a qualitative study using the content analysis approach. The participants consisted of seventeen nursing students and three nursing instructors. The participants were selected through purposive sampling method and attended semistructured interviews and focus groups.Results. Three themes emerged after data analysis, including ineffective communications, inadequate readiness, and emotional reactions.Conclusion. Nursing students in Iran are faced with many challenges in the clinical learning environment. All challenges identified in this study affected the students’ learning in clinical setting. Therefore, we recommend that the instructors prepare students with a specific focus on their communication and psychological needs.

scholarly journals Assessing the Clinical Learning Environment in an Institution in the United Arab Emirates: The Resident Perspective

2019 ◽  
Vol 11 (4s) ◽  
pp. 79-84 ◽  
Author(s):  
Indira Kannan ◽  
Thiagarajan Jaiganesh ◽  
Satish Chandrasekhar Nair ◽  
Yaaqoob Alhammadi ◽  
Bibi Fatima Ghulam Nabi ◽  
...  
Keyword(s):  
Patient Safety ◽  
Health Disparities ◽  
Learning Environment ◽  
United Arab Emirates ◽  
Health Care Quality ◽  
Care Transitions ◽  
The United States ◽  
Care Quality ◽  
Clinical Learning ◽  
Clinical Learning Environment

ABSTRACT Background A new accreditation model in the United States has increased focus on the clinical learning environment (CLE). There is limited research on trainee perceptions of the CLE in international settings. Objective We surveyed residents to obtain their perspective on the CLE at 1 sponsoring institution in the United Arab Emirates (UAE). Methods We surveyed residents at Tawam Hospital, UAE, a sponsoring institution with 142 trainees, on their perspectives in the 6 focal areas of the US Clinical Learning Environment Review (CLER) to gather baseline information. We administered a 26-item questionnaire to residents through an audience response system in November 2018. Results Of 100 residents in postgraduate year 2 and above, 72 (72%) responded. The perspective of the majority of respondents was favorable in the areas of reporting patient safety incidents, engaging in quality improvement activities, using a standardized form for care transition, and using professional guidelines for electronic health record documentation. In contrast, only half of the respondents perceived there is honesty in the reporting of duty hours, and only 36% felt the organization supported fatigue management. Other areas for improvement included residents' understanding of the concept of health disparities and activities to address health disparities. Conclusions Our findings suggest that in key focal areas related to patient safety, health care quality, care transitions, and professionalism, UAE residents have similar perceptions of their CLE as US trainees. Opportunities for improvement include duty hour reporting, fatigue mitigation, and addressing health disparities.

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