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Presentation 1 - Preparation for Safe Practice as an Intern


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Presentation by Dr James Edwards

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Presentation 1 - Preparation for Safe Practice as an Intern

  1. 1. 1 Right Start ForumPreparing for Safe Practice as an Intern (PSPI Program) Presenter: Dr James Edwards Project Partners: Sydney Medical School Northern Sydney Local Health District Sydney Local Health District Team Health Right Start Program Showcase 27 February 2012
  2. 2. 2 Faculty Merrilyn Walton: Professor of Medical  Jennifer-Smith Merry: Research Fellow, School of Education (Patient Safety) School of Public Public Health Health, Sydney Medical School  Susan McKenzie, Clinical Lecturer, Sydney Medical Stewart Dunn: Professor of Psychological School Medicine, Northern Clinical School  Clare Richmond: Emergency Physician, Simulation James Edwards: Emergency Physician, Royal Fellow, RNSH, RPAH Prince Alfred Hospital  Gillian Nisbet, PhD candidate & project manager Kar-Soon Lim: Senior Lecturer  Barbara Cassidy, Educational design instructor Anaesthesia, Concord Clinical School  Beth Vogelzang (Acting) Nursing Unit Vasi Naganathan: Ass. Professor Manager, Concord Repatriation General Hospital Medicine, Concord Clinical School, Centre for Education and Research on Ageing (CRGH)  Evelyn Dalton Manager Clinical Simulation Laboratory/Academic Sydney Nursing School Leonnie Watterson: Clinical Associate Professor, Anaesthesia, Northern Clinical  Registrars and resident medical School, Director officers, actors, volunteer nurses. Team Health Right Start Program Showcase 27 February 2012
  3. 3. 3Introduction & Background July phenomenon  Increased errors occur with new house staff at the beginning of the academic year  Inaba K, et al., Complications and death at the start of the new academic year: Is there a July phenomenon. The Journal of Trauma: Injury Infection and Critical care, 2010. 68(1): p. 19-22.  Haller G, et al., Rate of undesirable events at the beginning of academic year :retrospective cohort study. BMJ, 2009: p. 339:b3974. January phenomenon  Hilmer S, et al., Do medical courses adequately prepare interns for safe and effective prescribing in New South Wales public hospitals? Internal Medicine Journal, 2009. 39: p. 428-34. Team Health Right Start Program Showcase 27 February 2012
  4. 4. 4Aim & Methods Program Aim:  Reduce adverse events or the potential for adverse events for patients being treated by interns during their first months of employment. Learning Outcomes:  Demonstrate knowledge of and be confident in situations that have the potential to harm a patient  Identify the ‘red flag’ situations  Know when to seek assistance  Act appropriately to avoid an adverse event. Team Health Right Start Program Showcase 27 February 2012
  5. 5. 5Aim & Methods Program designed around 6 theme areas:  Clinical challenges – case management problems  Procedures – skills for discrete procedures  Organisational skills – clinical clerking – working safely and effectively within the system  The deteriorating patient – clinical emergencies  Interactive – patient doctor, colleague communication  Self-management – behaviours directed as self-regulation and professionalism 5 Day experiential program for pre-intern medical students:  Case-based learning; simulations; workshops; role plays Team Health Right Start Program Showcase 27 February 2012
  6. 6. 6Results Process evaluation  37 Pre-internship medical students  70% of participants rated Program 8 out of 10 or above  Clinically focused sessions well received:  Active participation - time for practice and questions  Based on real cases/ real mistakes – met immediate needs of participants  Participants ‘put in situation’ – i.e. it could have been them that had made the mistake  All but 4 participants indicated that all final year medical students would benefit from such a course Impact evaluation - ongoing Team Health Right Start Program Showcase 27 February 2012
  7. 7. 7Conclusions & Lessons Learned PSPI program fills the gap in transition from student to practitioner Maintain clinical focus on avoiding adverse events:  Retain the most effective and efficient learning methods  Integrate communication skills development into clinical case scenarios rather than a separate session  Provide opportunities for individual feedback on performance Clinician teachers are prepared and include  Clinician educators with recent graduate experience  Experienced clinicians with teaching and supervisory responsibilities Team Health Right Start Program Showcase 27 February 2012
  8. 8. 8Where to from here? Finalise the PSPI Curriculum Guide incorporating:  Principles and background for content covered and teaching strategies adopted (i.e. how to teach)  Comprehensive description of topics, resources and facilitator actions Develop the PSPI Facilitator Training Program (How to teach) Make available the PSPI program to all medical schools Continue research plan to evaluate the longer term impact of PSPI Program Opportunities for IPL?? Team Health Right Start Program Showcase 27 February 2012