The Telluride Interdisciplinary Roundtable met in 2005 and 2006 to design a comprehensive patient safety curriculum for medical students. The group developed 11 specific curricular elements and identified challenges to implementation. A patient safety curriculum was successfully developed over two years. Future meetings focused on evaluating pilots of the curriculum in medical schools and developing new ideas. Continued collaboration between professions will help create a standardized longitudinal patient safety curriculum.
This document provides a summary of the World Health Organization's Patient Safety Curriculum Guide: Multi-professional Edition. It is intended to educate health professions students on patient safety and was developed through collaboration between WHO, various international health organizations, and experts in multiple disciplines. The guide aims to strengthen competencies around patient safety and help prepare future health workers to deliver safer care. It provides educational principles and practical tools to integrate patient safety learning into existing health professions curricula worldwide.
This document is the introduction to the WHO Patient Safety Curriculum Guide: Multi-professional Edition. It discusses how patient safety has become a global priority in healthcare over the past 20 years since influential reports highlighted that errors are common in healthcare and can cause serious harm. It recognizes that while efforts have been made to improve patient safety, unsafe care remains a concern worldwide. It presents the Curriculum Guide as a new approach to strengthening the education of healthcare professionals in patient safety principles and practices to help address ongoing safety challenges.
Evaluation of a tool for assessing clinical competence of msc nurse studentsAlexander Decker
The document reports on the first phase of a study which evaluated an existing clinical competence assessment tool used for MSc nurse students in Kenya. Twenty-seven nurse experts participated in the study and found that the existing tool had low content validity and needed revision. Specifically, the study found that only 7 of 34 items met the minimum content validity index threshold, and the tool had an average congruency percentage of only 60%. This indicates a need to revise the tool by adding and removing some competencies to better assess clinical competence.
Cme model of dmims (du) wardha the 10 point action program for learning and q...Alexander Decker
The article discusses the 10 point action program for continuing medical education (CME) at Datta Meghe Institute of Medical Sciences (DMIMS) in India. Key points of the program include:
1. Providing grants for CME activities to reduce influence from pharmaceutical companies and support preclinical departments.
2. Conducting needs assessments to identify gaps and design relevant CME activities.
3. Providing pre-CME counseling to set objectives and design effective activities.
4. Preparing an annual CME calendar and obtaining university approval and budget.
5. Ensuring accreditation standards are met and credit is allocated for activities.
The goal of the 10 point program is to make
This document discusses integrating patient safety education into the undergraduate obstetrics and gynecology curriculum. It provides a literature review on existing patient safety curricula and assessments. The key points are:
1) While patient safety initiatives have increased in healthcare, medical student involvement remains limited. Incorporating students can help meet Accreditation Council for Graduate Medical Education competency milestones.
2) The literature provides some examples of successful patient safety curricula covering topics like teamwork, universal precautions, and aseptic technique. However, most studies lack outcome data proving the curricula changed student behavior.
3) High-fidelity simulations and skills training show promise in teaching concepts like team communication,
This document summarizes a presentation given at a patient safety conference about implementing a "just culture" approach at Tawam Hospital in the United Arab Emirates. It discusses adopting the Comprehensive Unit-based Safety Program (CUSP) to assess safety culture, educate staff, and improve communication and teamwork. Initial surveys found room for improvement in safety attitudes. CUSP was expanded to more units over time and subsequent surveys showed increases in positive safety culture scores. Infection rates like CLABSI declined as well. The presentation highlights challenges faced and lessons learned from the culture change journey.
The document examines the implementation of patient safety and patient-centeredness strategies in 84 Iranian hospitals based on a survey completed by hospital and nursing managers in 2009-2010. It finds that the majority of hospitals reported implementing 84% of patient safety strategies and 72% of patient-centeredness strategies. Implementation of most strategies was generally unrelated to hospital characteristics like type, ownership, teaching status, or annual evaluation grade, with some exceptions. Overall implementation of strategies was substantial but there is still room for improvement, including enforcing standards, increasing organizational responsiveness, and partnering with patients.
Intensive care nurses’ knowledge & practices regardingAlexander Decker
1. The study assessed the knowledge and practices of 77 intensive care unit nurses regarding infection control standard precautions at a cancer hospital in Egypt.
2. The results found that over 63% of nurses had unsatisfactory knowledge levels, though over 57% had satisfactory performance adhering to standard precautions.
3. There were negative correlations between knowledge/performance and age/experience, but positive correlations between knowledge and performance. The study concluded nurses had unsatisfactory knowledge despite satisfactory performance, and recommended continued education programs to update knowledge and adherence to best practices.
This document provides a summary of the World Health Organization's Patient Safety Curriculum Guide: Multi-professional Edition. It is intended to educate health professions students on patient safety and was developed through collaboration between WHO, various international health organizations, and experts in multiple disciplines. The guide aims to strengthen competencies around patient safety and help prepare future health workers to deliver safer care. It provides educational principles and practical tools to integrate patient safety learning into existing health professions curricula worldwide.
This document is the introduction to the WHO Patient Safety Curriculum Guide: Multi-professional Edition. It discusses how patient safety has become a global priority in healthcare over the past 20 years since influential reports highlighted that errors are common in healthcare and can cause serious harm. It recognizes that while efforts have been made to improve patient safety, unsafe care remains a concern worldwide. It presents the Curriculum Guide as a new approach to strengthening the education of healthcare professionals in patient safety principles and practices to help address ongoing safety challenges.
Evaluation of a tool for assessing clinical competence of msc nurse studentsAlexander Decker
The document reports on the first phase of a study which evaluated an existing clinical competence assessment tool used for MSc nurse students in Kenya. Twenty-seven nurse experts participated in the study and found that the existing tool had low content validity and needed revision. Specifically, the study found that only 7 of 34 items met the minimum content validity index threshold, and the tool had an average congruency percentage of only 60%. This indicates a need to revise the tool by adding and removing some competencies to better assess clinical competence.
Cme model of dmims (du) wardha the 10 point action program for learning and q...Alexander Decker
The article discusses the 10 point action program for continuing medical education (CME) at Datta Meghe Institute of Medical Sciences (DMIMS) in India. Key points of the program include:
1. Providing grants for CME activities to reduce influence from pharmaceutical companies and support preclinical departments.
2. Conducting needs assessments to identify gaps and design relevant CME activities.
3. Providing pre-CME counseling to set objectives and design effective activities.
4. Preparing an annual CME calendar and obtaining university approval and budget.
5. Ensuring accreditation standards are met and credit is allocated for activities.
The goal of the 10 point program is to make
This document discusses integrating patient safety education into the undergraduate obstetrics and gynecology curriculum. It provides a literature review on existing patient safety curricula and assessments. The key points are:
1) While patient safety initiatives have increased in healthcare, medical student involvement remains limited. Incorporating students can help meet Accreditation Council for Graduate Medical Education competency milestones.
2) The literature provides some examples of successful patient safety curricula covering topics like teamwork, universal precautions, and aseptic technique. However, most studies lack outcome data proving the curricula changed student behavior.
3) High-fidelity simulations and skills training show promise in teaching concepts like team communication,
This document summarizes a presentation given at a patient safety conference about implementing a "just culture" approach at Tawam Hospital in the United Arab Emirates. It discusses adopting the Comprehensive Unit-based Safety Program (CUSP) to assess safety culture, educate staff, and improve communication and teamwork. Initial surveys found room for improvement in safety attitudes. CUSP was expanded to more units over time and subsequent surveys showed increases in positive safety culture scores. Infection rates like CLABSI declined as well. The presentation highlights challenges faced and lessons learned from the culture change journey.
The document examines the implementation of patient safety and patient-centeredness strategies in 84 Iranian hospitals based on a survey completed by hospital and nursing managers in 2009-2010. It finds that the majority of hospitals reported implementing 84% of patient safety strategies and 72% of patient-centeredness strategies. Implementation of most strategies was generally unrelated to hospital characteristics like type, ownership, teaching status, or annual evaluation grade, with some exceptions. Overall implementation of strategies was substantial but there is still room for improvement, including enforcing standards, increasing organizational responsiveness, and partnering with patients.
Intensive care nurses’ knowledge & practices regardingAlexander Decker
1. The study assessed the knowledge and practices of 77 intensive care unit nurses regarding infection control standard precautions at a cancer hospital in Egypt.
2. The results found that over 63% of nurses had unsatisfactory knowledge levels, though over 57% had satisfactory performance adhering to standard precautions.
3. There were negative correlations between knowledge/performance and age/experience, but positive correlations between knowledge and performance. The study concluded nurses had unsatisfactory knowledge despite satisfactory performance, and recommended continued education programs to update knowledge and adherence to best practices.
KNOWLEDGE OF NURSES ON NATIONAL PRESSURE ULCER PREVENTION GUIDELINES IN EMBU ...AM Publications
This document summarizes a study that assessed nurses' knowledge of national pressure ulcer prevention guidelines in Embu, Kenya. The study found that:
1) Most nurses (85.6%) had adequate knowledge of the guidelines based on a mean score of 87.5%, while 14.4% had inadequate knowledge.
2) Qualification, attendance of continuous professional development sessions, and years of experience significantly affected nurses' knowledge levels.
3) Nurses with a degree qualification had higher knowledge scores than those with a diploma, and nurses who attended previous training sessions scored higher than those who did not.
Contents lists available at science directnurse education tRAJU852744
This study aimed to determine how nursing students transfer theoretical knowledge to clinical practice and the difficulties they experience. The researchers conducted focus group interviews with 30 nursing students. The students reported that their theoretical knowledge was extensive but they struggled to apply it clinically. They lacked clinical skills and were afraid to touch patients from a fear of making mistakes. The students also reported not receiving adequate guidance from instructors in clinical settings. Some instructors were too distant or strict, making students hesitant to ask questions. Communication problems were also experienced with some nurses and clinical instructors who did not cooperate with students.
Creativity and innovation in Biomedical sciences, a non-formal approach Adela Banciu
It was organized a non-formal course with the objectives to increase the capacity to develop research projects, understanding and critical interpretation of scientific articles, changing their ideas into research projects, in order to fulfill the need of students to be involved in research.
Efficacy of Demonstration on Covid 19 Training on Knowledge Among Final Year ...YogeshIJTSRD
This study aimed to assess the effectiveness of demonstration on knowledge regarding covid 19 training among final year nursing students of dr. achal singh yadav institute of nursing and paramedical sciences, lucknow. a quanatitave research approach with quasi experimental research design was used to select 37 final year nursing students. self structured knowledge questionnaire was used for assessing the knowledge regarding covid 19 training among the subjects. spss version 25 was used for analyzing the data. result revealed that in pretest no sample had adequate knowledge as compare to post test 32 students had adequate knowledge regarding covid 19 training. the paired t test shows that obtained p value was 0.008 which is less than p value 0.05 reveal that demonstration was effective to bring changes in knowledge regarding covid 19 training among the participants and chisqaure test reveal that there is no significant association with pretest knowledge on covid 19 training and demographic variables of participant except course of study. Jubin Varghese | Bhoopendra Singh Yadav | Saniya Susan Issac "Efficacy of Demonstration on Covid-19 Training on Knowledge Among Final Year Nursing Students of Dr. Achal Singh Yadav Institute of Nursing and Paramedical Sciences, Lucknow" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4 , June 2021, URL: https://www.ijtsrd.compapers/ijtsrd41257.pdf Paper URL: https://www.ijtsrd.commedicine/nursing/41257/efficacy-of-demonstration-on-covid19-training-on-knowledge-among-final-year-nursing-students-of-dr-achal-singh-yadav-institute-of-nursing-and-paramedical-sciences-lucknow/jubin-varghese
- The document reviews research literature on fall prevention programs in acute care settings.
- Four meta-analyses and randomized controlled trials found that multicomponent fall prevention programs, including risk assessment, education, and post-fall evaluations, can reduce falls by up to 30%.
- Studies also found that implementing a falls safety champion, in addition to multifactorial interventions, was associated with reductions in injurious falls by 58% and total falls by 27%, resulting in estimated savings of $776,064 and $450,000 annually.
Strategies for Improving the Retention of Engineering and Technology Students...drboon
Retention is a major factor in an institution’s credibility and financial stability. A greater emphasis is being placed on retention and attrition in higher education in the United States. While lack of persistence behavior and withdrawal are problems with all undergraduate students, this is particularly the case for African-American students. The barriers to minority student retention continue to be: the cost of education, isolating campus environments, a lack of peer and faculty engagement, inadequate math and science preparation, heavy work schedule hours versus class preparation. To minimize the impact of this disturbing trend of students not pursuing an engineering or technology degree, a priority must be set to generate student interest in graduation with these degrees. The objectives of this paper are: (1) to define an effective retention program, (2) to discuss general retention strategies, (3) to identify challenges or barriers to overcome a lack of retention of engineering and technology students, (4) to discuss retention strategies used at an HBCU or Southern University (SU), and (5) to provide recommendations for improvement of retention in the College of Engineering at SU.
A Descriptive Study to Assess the Level of Anxiety among B.Sc. Nursing 1st Ye...YogeshIJTSRD
A quantitative descriptive study was undertaken to assess the level of Anxiety towards exposure to hospital environment among B.Sc. Nursing 1st year student at Apex College of Nursing, Varanasi, India. 100 students were selected through convenience sampling technique and data was collected by using beck anxiety inventory scale. Nursing 1st Year Students Regarding Exposure to Hospital Environment in Selected College of Nursing at Varanasi, India" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45024.pdf Paper URL: https://www.ijtsrd.com/medicine/nursing/45024/a-descriptive-study-to-assess-the-level-of-anxiety-among-bsc-nursing-1st-year-students-regarding-exposure-to-hospital-environment-in-selected-college-of-nursing-at-varanasi-india/ms-anushi
The best way to enhance patient safety is to build a culture of safety at the hospital. The Johns Hopkins Hospital Comprehensive Unit-based Safety Program (CUSP)
Anxiety, uncertainty, and resilience of medical students worldwide during the...Ahmad Ozair
The COVID-19 pandemic significantly impacted medical education worldwide. While healthcare professionals labored to ensure proper care for COVID-19 patients, medical students suffered from high rates of anxiety, uncertainty, burnout, and depressive symptoms. Whilst students in the pre-clinical phase of education faced disruption of didactic lectures and laboratory training, senior medical students faced uncertainty regarding their clinical rotations and internships, which are vital for practical exposure to healthcare. Several studies across the world demonstrated that clinical learning was significantly affected, with students in many countries completely cut off from in-person rotations. The disruption of the clinical curriculum coupled with a sense of failure to contribute at a time of significant need often led to despair. Reforms proposed and/or implemented by governments, medical advisory boards, medical schools, and other administrative bodies were felt to be insufficient by the medical student fraternity at large. Consequently, these students continue to face high rates of anxiety, depression, and a general sense of cynicism. In this student-authored perspective, we highlight the challenges faced by and the psychological impact on medical students directly or indirectly from the pandemic.
Universal Assessment Challenges in Health Care Related EducationExamSoft
This document provides an overview of a webinar presentation on universal assessment challenges in healthcare related education. It discusses establishing context through both external drivers like accreditation standards, and internal drivers from various stakeholder perspectives. It then covers specific challenges around capturing assessment data through coding test items and curriculum mapping, as well as analyzing the data through learning analytics to inform curriculum and instruction improvements.
This document provides an overview of the Global Initiative for Asthma (GINA) and its 2014 strategy report for asthma management and prevention. GINA is an international collaboration of healthcare professionals and organizations working to improve asthma care worldwide. The report was developed by GINA's Board of Directors and Science Committee, with input from additional contributors and external reviewers. It provides evidence-based recommendations for diagnosing and treating asthma across all age groups. The goal is to help improve asthma control and reduce the global health burden of this chronic condition through implementation of effective clinical guidelines.
This document proposes a prospective study to scale up surgical care at a rural hospital in Nepal using the WHO's Integrated Management for Emergency and Essential Surgical Care (IMEESC) model plus additional community follow-up and quality improvement methods. The study aims to rigorously evaluate this innovative model, pilot an implementation research methodology, and generate data to inform larger scale-up of surgical care worldwide. Specific objectives include describing the implementation process and measuring quality through adherence to protocols, follow-up rates, and complication rates. Metrics are proposed for evaluating pre-op, intra-op, post-op, facilities/supplies, and community follow-up. The study seeks to provide needed research on deploying surgical care in low-
A comparative study of completion challenges facing regular and parallel degr...Alexander Decker
This document summarizes a study that compared completion challenges facing regular and parallel degree students at Egerton University constituent colleges in Kenya. The study found that fewer parallel degree students received loans from HELB compared to regular students. Parallel students also had less access to morning/evening lectures, co-curricular activities, and course selection. They faced challenges accessing lecture halls, deans, lecturers, and libraries, impacting their completion rates compared to regular students. The study used questionnaires and documentation to examine the effect of financial challenges, access to teaching/learning resources, and student welfare on retention and completion rates.
A Study to Assess the Level of Knowledge Regarding Airway Management Modaliti...ijtsrd
INTRODUCTION Airway management includes a set of maneuvers and medical procedures performed to prevent and relieve airway obstruction. Due to obstruction in the airway the life of the individual is in danger so use of airway management modalities will help to save the individual’s life. These modalities ensures an open pathway which provide breath to the lungs through the atmospheric air and mechanical support to secure life. The study was conducted to assess the level of knowledge on airway management among Nursing student. The main objectives of study were to assess the knowledge on airway management modalities and to associate the level of knowledge with selected demographic variables. A Quantitative research approach with Descriptive research design was used to evaluate the knowledge regarding airway management modalities. A sample of 60nursing students were selected by convenient sampling technique. structured questionnaire was used to obtain data from the sample . Data analysis was done by using descriptive and inferential statistics on the basis of objective of the study RESULT The result of the study shows that out of 60 samples 13 21.66 having good knowledge 45 75.3 having average knowledge and 2 3.33 having poor knowledge regarding airway management modalities. with regard to mean and standard deviation of knowledge shows 17.3 and 3.92 respectively. CONCLUSION The study concludes that, the knowledge level of students regarding airway management modalities associated airway management is average, the study suggest that proper teaching and adequate training on airway management will be helpful for the students to gain knowledge. Mr. Pradip Kumar Mishra | Mr. Raghavendran M "A Study to Assess the Level of Knowledge Regarding Airway Management Modalities among Nursing Student at Selected Nursing, College Kanpur" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45205.pdf Paper URL: https://www.ijtsrd.com/medicine/nursing/45205/a-study-to-assess-the-level-of-knowledge-regarding-airway-management-modalities-among-nursing-student-at-selected-nursing-college-kanpur/mr-pradip-kumar-mishra
This document discusses the demand for highly qualified personnel in Canada for therapeutic evaluation. It notes that achieving optimal therapeutics requires a balanced approach including discovery research, clinical investigation, evaluation, regulatory, and implementation sciences. However, Canada is facing shortfalls in these research skills outside of government and industry based on a 2010 Health Canada survey. The document argues that this represents an opportunity for academic institutions to help meet the needs of the Canadian public by training more students in these areas. Government funding for universities should support delivering graduates with these skills.
GSPOA World Health Summit Workshop, UsmanUsman Mushtaq
This document summarizes a presentation given by Usman A. Mushtaq on global strategies for public health innovation and intellectual property. The presentation argues that current IP rights do not do enough to empower low and middle income countries to address their disease burdens and health inequities. It provides the rationale that restricted sharing of biotechnology and IP in LMICs violates human rights and ethics. The strategy proposes over 100 action points led by WHO to build LMIC capacity, utilize flexibilities in IP laws, and promote needs-based innovation. However, challenges remain in implementation across governing bodies and reconciling trade and health interests. Student advocacy groups are working to address these issues and promote curriculum on global health needs.
Personal protective equipment or PPE has been a major topic of discussion across the nation. The COVID-19 pandemic has exposed major shortages of PPE and health care workers are being asked take care of patients with what some would argue is inadequate protection. The guidelines set by the CDC have changed and recommendations have even gone so far as to approve bandannas as a means for respiratory protection. Some have argued that it is unethical for health care workers to not have adequate protection, while others think it's their duty, protected or not. Adding to this debate has been theft, hoarding and disparate distribution of these critical supplies. During this panel discussion moderator Carmel Shachar, Stephen P. Wood, Christine Mitchell and Dr. Michael Mina explored the ethics of PPE in the COVID-19 pandemic.
Promoting clinical research within the AHP's - Angela Green & Sarah ReelSHUAHP
This document discusses promoting clinical research within allied health professions. It outlines several organizations that support clinical research, including the National Institute for Health Research (NIHR), Clinical Research Networks, the Collaboration for Leadership in Applied Health Research and Care (CLAHRC), Academic Health Science Networks, universities, and profession-specific research networks. The document specifically discusses the NIHR, Yorkshire and Humber Clinical Research Network, and the AHP specialty research network's goals of increasing allied health professionals' research capacity and recruitment to studies.
Article Type: Editorial
Title: Patient Safety: Paradigm shift of modern healthcare delivery and research
Year: 2022; Volume: 2; Issue: 1; Page No: 1 – 2
Author: Dr. Mohammed Imran
10.55349/ijmsnr.20222112
Affiliation: Associate Professor, Medical Pharmacology, College of Medicine and Health Sciences, Sohar, National University of Science and Technology, Sultanate of Oman.
Email ID: imran@nu.edu.om
Article Summary:
Submitted : 10-February-2022
Revised : 26-February-2022
Accepted : 12-March-2022
Published : 31-March-2022
The document discusses medical education in the 21st century. It begins with an overview of trends in U.S. undergraduate medical education including longitudinal clinical programs and a movement toward competency-based evaluations using Entrustable Professional Activities (EPAs). Next, it discusses changes in clinical undergraduate medical education such as longitudinal integrated clerkships and EPA-based evaluations. Finally, it reviews graduate medical education, noting new requirements from the ACGME, and novel approaches using digital resources, asynchronous learning theory, and social media.
The document discusses medical education and proposes that students have gaps in their clinical pathology knowledge even in their senior year, highlighting issues identified in a pre-test. It then describes a two-week course given to fourth-year medical students to address these gaps, focusing on case-based teaching and discussions of primary literature. The conclusion is that identifying and remediating gaps is important given standards of 100% performance are needed for success in some medical areas.
KNOWLEDGE OF NURSES ON NATIONAL PRESSURE ULCER PREVENTION GUIDELINES IN EMBU ...AM Publications
This document summarizes a study that assessed nurses' knowledge of national pressure ulcer prevention guidelines in Embu, Kenya. The study found that:
1) Most nurses (85.6%) had adequate knowledge of the guidelines based on a mean score of 87.5%, while 14.4% had inadequate knowledge.
2) Qualification, attendance of continuous professional development sessions, and years of experience significantly affected nurses' knowledge levels.
3) Nurses with a degree qualification had higher knowledge scores than those with a diploma, and nurses who attended previous training sessions scored higher than those who did not.
Contents lists available at science directnurse education tRAJU852744
This study aimed to determine how nursing students transfer theoretical knowledge to clinical practice and the difficulties they experience. The researchers conducted focus group interviews with 30 nursing students. The students reported that their theoretical knowledge was extensive but they struggled to apply it clinically. They lacked clinical skills and were afraid to touch patients from a fear of making mistakes. The students also reported not receiving adequate guidance from instructors in clinical settings. Some instructors were too distant or strict, making students hesitant to ask questions. Communication problems were also experienced with some nurses and clinical instructors who did not cooperate with students.
Creativity and innovation in Biomedical sciences, a non-formal approach Adela Banciu
It was organized a non-formal course with the objectives to increase the capacity to develop research projects, understanding and critical interpretation of scientific articles, changing their ideas into research projects, in order to fulfill the need of students to be involved in research.
Efficacy of Demonstration on Covid 19 Training on Knowledge Among Final Year ...YogeshIJTSRD
This study aimed to assess the effectiveness of demonstration on knowledge regarding covid 19 training among final year nursing students of dr. achal singh yadav institute of nursing and paramedical sciences, lucknow. a quanatitave research approach with quasi experimental research design was used to select 37 final year nursing students. self structured knowledge questionnaire was used for assessing the knowledge regarding covid 19 training among the subjects. spss version 25 was used for analyzing the data. result revealed that in pretest no sample had adequate knowledge as compare to post test 32 students had adequate knowledge regarding covid 19 training. the paired t test shows that obtained p value was 0.008 which is less than p value 0.05 reveal that demonstration was effective to bring changes in knowledge regarding covid 19 training among the participants and chisqaure test reveal that there is no significant association with pretest knowledge on covid 19 training and demographic variables of participant except course of study. Jubin Varghese | Bhoopendra Singh Yadav | Saniya Susan Issac "Efficacy of Demonstration on Covid-19 Training on Knowledge Among Final Year Nursing Students of Dr. Achal Singh Yadav Institute of Nursing and Paramedical Sciences, Lucknow" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4 , June 2021, URL: https://www.ijtsrd.compapers/ijtsrd41257.pdf Paper URL: https://www.ijtsrd.commedicine/nursing/41257/efficacy-of-demonstration-on-covid19-training-on-knowledge-among-final-year-nursing-students-of-dr-achal-singh-yadav-institute-of-nursing-and-paramedical-sciences-lucknow/jubin-varghese
- The document reviews research literature on fall prevention programs in acute care settings.
- Four meta-analyses and randomized controlled trials found that multicomponent fall prevention programs, including risk assessment, education, and post-fall evaluations, can reduce falls by up to 30%.
- Studies also found that implementing a falls safety champion, in addition to multifactorial interventions, was associated with reductions in injurious falls by 58% and total falls by 27%, resulting in estimated savings of $776,064 and $450,000 annually.
Strategies for Improving the Retention of Engineering and Technology Students...drboon
Retention is a major factor in an institution’s credibility and financial stability. A greater emphasis is being placed on retention and attrition in higher education in the United States. While lack of persistence behavior and withdrawal are problems with all undergraduate students, this is particularly the case for African-American students. The barriers to minority student retention continue to be: the cost of education, isolating campus environments, a lack of peer and faculty engagement, inadequate math and science preparation, heavy work schedule hours versus class preparation. To minimize the impact of this disturbing trend of students not pursuing an engineering or technology degree, a priority must be set to generate student interest in graduation with these degrees. The objectives of this paper are: (1) to define an effective retention program, (2) to discuss general retention strategies, (3) to identify challenges or barriers to overcome a lack of retention of engineering and technology students, (4) to discuss retention strategies used at an HBCU or Southern University (SU), and (5) to provide recommendations for improvement of retention in the College of Engineering at SU.
A Descriptive Study to Assess the Level of Anxiety among B.Sc. Nursing 1st Ye...YogeshIJTSRD
A quantitative descriptive study was undertaken to assess the level of Anxiety towards exposure to hospital environment among B.Sc. Nursing 1st year student at Apex College of Nursing, Varanasi, India. 100 students were selected through convenience sampling technique and data was collected by using beck anxiety inventory scale. Nursing 1st Year Students Regarding Exposure to Hospital Environment in Selected College of Nursing at Varanasi, India" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45024.pdf Paper URL: https://www.ijtsrd.com/medicine/nursing/45024/a-descriptive-study-to-assess-the-level-of-anxiety-among-bsc-nursing-1st-year-students-regarding-exposure-to-hospital-environment-in-selected-college-of-nursing-at-varanasi-india/ms-anushi
The best way to enhance patient safety is to build a culture of safety at the hospital. The Johns Hopkins Hospital Comprehensive Unit-based Safety Program (CUSP)
Anxiety, uncertainty, and resilience of medical students worldwide during the...Ahmad Ozair
The COVID-19 pandemic significantly impacted medical education worldwide. While healthcare professionals labored to ensure proper care for COVID-19 patients, medical students suffered from high rates of anxiety, uncertainty, burnout, and depressive symptoms. Whilst students in the pre-clinical phase of education faced disruption of didactic lectures and laboratory training, senior medical students faced uncertainty regarding their clinical rotations and internships, which are vital for practical exposure to healthcare. Several studies across the world demonstrated that clinical learning was significantly affected, with students in many countries completely cut off from in-person rotations. The disruption of the clinical curriculum coupled with a sense of failure to contribute at a time of significant need often led to despair. Reforms proposed and/or implemented by governments, medical advisory boards, medical schools, and other administrative bodies were felt to be insufficient by the medical student fraternity at large. Consequently, these students continue to face high rates of anxiety, depression, and a general sense of cynicism. In this student-authored perspective, we highlight the challenges faced by and the psychological impact on medical students directly or indirectly from the pandemic.
Universal Assessment Challenges in Health Care Related EducationExamSoft
This document provides an overview of a webinar presentation on universal assessment challenges in healthcare related education. It discusses establishing context through both external drivers like accreditation standards, and internal drivers from various stakeholder perspectives. It then covers specific challenges around capturing assessment data through coding test items and curriculum mapping, as well as analyzing the data through learning analytics to inform curriculum and instruction improvements.
This document provides an overview of the Global Initiative for Asthma (GINA) and its 2014 strategy report for asthma management and prevention. GINA is an international collaboration of healthcare professionals and organizations working to improve asthma care worldwide. The report was developed by GINA's Board of Directors and Science Committee, with input from additional contributors and external reviewers. It provides evidence-based recommendations for diagnosing and treating asthma across all age groups. The goal is to help improve asthma control and reduce the global health burden of this chronic condition through implementation of effective clinical guidelines.
This document proposes a prospective study to scale up surgical care at a rural hospital in Nepal using the WHO's Integrated Management for Emergency and Essential Surgical Care (IMEESC) model plus additional community follow-up and quality improvement methods. The study aims to rigorously evaluate this innovative model, pilot an implementation research methodology, and generate data to inform larger scale-up of surgical care worldwide. Specific objectives include describing the implementation process and measuring quality through adherence to protocols, follow-up rates, and complication rates. Metrics are proposed for evaluating pre-op, intra-op, post-op, facilities/supplies, and community follow-up. The study seeks to provide needed research on deploying surgical care in low-
A comparative study of completion challenges facing regular and parallel degr...Alexander Decker
This document summarizes a study that compared completion challenges facing regular and parallel degree students at Egerton University constituent colleges in Kenya. The study found that fewer parallel degree students received loans from HELB compared to regular students. Parallel students also had less access to morning/evening lectures, co-curricular activities, and course selection. They faced challenges accessing lecture halls, deans, lecturers, and libraries, impacting their completion rates compared to regular students. The study used questionnaires and documentation to examine the effect of financial challenges, access to teaching/learning resources, and student welfare on retention and completion rates.
A Study to Assess the Level of Knowledge Regarding Airway Management Modaliti...ijtsrd
INTRODUCTION Airway management includes a set of maneuvers and medical procedures performed to prevent and relieve airway obstruction. Due to obstruction in the airway the life of the individual is in danger so use of airway management modalities will help to save the individual’s life. These modalities ensures an open pathway which provide breath to the lungs through the atmospheric air and mechanical support to secure life. The study was conducted to assess the level of knowledge on airway management among Nursing student. The main objectives of study were to assess the knowledge on airway management modalities and to associate the level of knowledge with selected demographic variables. A Quantitative research approach with Descriptive research design was used to evaluate the knowledge regarding airway management modalities. A sample of 60nursing students were selected by convenient sampling technique. structured questionnaire was used to obtain data from the sample . Data analysis was done by using descriptive and inferential statistics on the basis of objective of the study RESULT The result of the study shows that out of 60 samples 13 21.66 having good knowledge 45 75.3 having average knowledge and 2 3.33 having poor knowledge regarding airway management modalities. with regard to mean and standard deviation of knowledge shows 17.3 and 3.92 respectively. CONCLUSION The study concludes that, the knowledge level of students regarding airway management modalities associated airway management is average, the study suggest that proper teaching and adequate training on airway management will be helpful for the students to gain knowledge. Mr. Pradip Kumar Mishra | Mr. Raghavendran M "A Study to Assess the Level of Knowledge Regarding Airway Management Modalities among Nursing Student at Selected Nursing, College Kanpur" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45205.pdf Paper URL: https://www.ijtsrd.com/medicine/nursing/45205/a-study-to-assess-the-level-of-knowledge-regarding-airway-management-modalities-among-nursing-student-at-selected-nursing-college-kanpur/mr-pradip-kumar-mishra
This document discusses the demand for highly qualified personnel in Canada for therapeutic evaluation. It notes that achieving optimal therapeutics requires a balanced approach including discovery research, clinical investigation, evaluation, regulatory, and implementation sciences. However, Canada is facing shortfalls in these research skills outside of government and industry based on a 2010 Health Canada survey. The document argues that this represents an opportunity for academic institutions to help meet the needs of the Canadian public by training more students in these areas. Government funding for universities should support delivering graduates with these skills.
GSPOA World Health Summit Workshop, UsmanUsman Mushtaq
This document summarizes a presentation given by Usman A. Mushtaq on global strategies for public health innovation and intellectual property. The presentation argues that current IP rights do not do enough to empower low and middle income countries to address their disease burdens and health inequities. It provides the rationale that restricted sharing of biotechnology and IP in LMICs violates human rights and ethics. The strategy proposes over 100 action points led by WHO to build LMIC capacity, utilize flexibilities in IP laws, and promote needs-based innovation. However, challenges remain in implementation across governing bodies and reconciling trade and health interests. Student advocacy groups are working to address these issues and promote curriculum on global health needs.
Personal protective equipment or PPE has been a major topic of discussion across the nation. The COVID-19 pandemic has exposed major shortages of PPE and health care workers are being asked take care of patients with what some would argue is inadequate protection. The guidelines set by the CDC have changed and recommendations have even gone so far as to approve bandannas as a means for respiratory protection. Some have argued that it is unethical for health care workers to not have adequate protection, while others think it's their duty, protected or not. Adding to this debate has been theft, hoarding and disparate distribution of these critical supplies. During this panel discussion moderator Carmel Shachar, Stephen P. Wood, Christine Mitchell and Dr. Michael Mina explored the ethics of PPE in the COVID-19 pandemic.
Promoting clinical research within the AHP's - Angela Green & Sarah ReelSHUAHP
This document discusses promoting clinical research within allied health professions. It outlines several organizations that support clinical research, including the National Institute for Health Research (NIHR), Clinical Research Networks, the Collaboration for Leadership in Applied Health Research and Care (CLAHRC), Academic Health Science Networks, universities, and profession-specific research networks. The document specifically discusses the NIHR, Yorkshire and Humber Clinical Research Network, and the AHP specialty research network's goals of increasing allied health professionals' research capacity and recruitment to studies.
Article Type: Editorial
Title: Patient Safety: Paradigm shift of modern healthcare delivery and research
Year: 2022; Volume: 2; Issue: 1; Page No: 1 – 2
Author: Dr. Mohammed Imran
10.55349/ijmsnr.20222112
Affiliation: Associate Professor, Medical Pharmacology, College of Medicine and Health Sciences, Sohar, National University of Science and Technology, Sultanate of Oman.
Email ID: imran@nu.edu.om
Article Summary:
Submitted : 10-February-2022
Revised : 26-February-2022
Accepted : 12-March-2022
Published : 31-March-2022
The document discusses medical education in the 21st century. It begins with an overview of trends in U.S. undergraduate medical education including longitudinal clinical programs and a movement toward competency-based evaluations using Entrustable Professional Activities (EPAs). Next, it discusses changes in clinical undergraduate medical education such as longitudinal integrated clerkships and EPA-based evaluations. Finally, it reviews graduate medical education, noting new requirements from the ACGME, and novel approaches using digital resources, asynchronous learning theory, and social media.
The document discusses medical education and proposes that students have gaps in their clinical pathology knowledge even in their senior year, highlighting issues identified in a pre-test. It then describes a two-week course given to fourth-year medical students to address these gaps, focusing on case-based teaching and discussions of primary literature. The conclusion is that identifying and remediating gaps is important given standards of 100% performance are needed for success in some medical areas.
The panel convened by the National Patient Safety Foundation to discuss the current state of patient safety 15 years after the seminal IOM report To Err Is Human identified several key points:
1) While awareness of patient safety issues has increased, progress has been slower than anticipated and the scale of improvement has been limited.
2) A total systems approach is needed to move beyond reactive, piecemeal interventions to prioritizing safety culture, developing the science of safety, and ensuring coordination across the care continuum and settings.
3) Specific recommendations include establishing safety leadership, centralized oversight, common safety metrics, increased research funding, addressing safety across all care settings, supporting the healthcare workforce, partnering with patients and families, and optim
This document discusses the rationale for engineering-based medical education. It begins by defining engineering education as focusing on skills like problem solving, systems integration, and continuous learning. It then defines engineering-based medical education as teaching both traditional medicine and principles of biomedical engineering. The document argues that an engineering-based approach could help address issues like rising healthcare costs, a focus on individual patients over populations, and a lack of emphasis on technology and team-based care. It provides examples of how engineering has advanced fields like 3D printing, gene editing, and mobile diagnostics. Overall, the document advocates for engineering-based medical education to better prepare future physicians for rapid advances in science and technology.
chapter 9 interprofessional practice, education, and research1. .docxchristinemaritza
chapter 9 interprofessional practice, education, and research
1. All health professionals and administrators have a duty to prevent avoidable injury and harm to all patients who receive health care in the United States. “Declare the past, diagnose the present, foretell the future; practice these acts. As to diseases, make a habit of two things—to help, or at leastp.254
2. to do no harm” (Hippocrates, Epidemics , Bk. 1, Sect. XI).p.254
3. Students of the health professions need to understand the science of safety and the translation of new discoveries for safer care delivery into practice. Patient harm secondary to errors and mishaps results from system problems and failures. Systems have both technical and human components. Understanding this interface necessitates work-ing together as health professionals to achieve systems improvement and reduce harm and injury. Current health professions education rarely delivers common core content about the science and applica-tion of safety principles.Creighton University presently offers one of the most comprehen-sive interdisciplinary patient safety courses in the country, entitled Interprofessional Education 410: Foundations in Patient Safety. The course has been offered since 2005 and has reached more than 500 students in training (Abbott, Fuji, Galt, & Paschal, 2012; Fuji, Paschal, Galt, & Abbott, 2010; Galt et al., 2006); however, not all students and faculty are being reached through this elective approach. Patient Safety Day was organized to reach all pre-health professions and health professions–related students on campus with a core exposure to the science of safety. The daylong event is built on the elective interprofessional core curriculum course and is offered once in each of the spring and fall semesters. The objective is to provide students and faculty with training in the science of safety simultaneous with an introduction to basic patient safety science principles in an interprofessional educational delivery framework. Content was designed to illustrate how safety impacts both the over-all healthcare system and the individual, and to apply lessons learned in a case-based interprofessional set of exercises. Three hundred fifty students participated in the first offeringp.255
4. of our Patient Safety Day, including 70 from medicine, 95 from nursing, 35 from occupational therapy, 85 from pharmacy, 57 from physical therapy, and 8 from social work. Speakers, panelists, and faculty facilitators participated from Creighton University, the U.S. Department of Veterans Affairs, state government, and the local community.“Today you made a difference” was the theme for this Patient Safety Day, and the focus was on the most personal and often tragicp.255
5. experiences of harm and injury of passionate leaders who conduct research, teach, implement research findings into practice, or use research findings to affect policy in patient safety. The keynote speaker, Evelyn McKnight, AuD, cofounder of Hono ...
By administering assessments and analyzing the results, targeted aTawnaDelatorrejs
By administering assessments and analyzing the results, targeted and individualized interventions can be determined to best serve the needs of students with disabilities. The actual implementation of the interventions provides teachers opportunities to collect data and gauge the effectiveness of the interventions in addressing documented student needs. Teachers can also gain important skills and knowledge on how to best advocate for practical classroom interventions. Teachers will also be able to collaborate with colleagues and families in mentoring students to take ownership of learning strategies.
Allocate at least 2 hours in the field to support this field experience,
Part 1: Assessment and Interventions
Select at least one student to whom you will administer the informal RTI assessment created in Clinical Field Experience A. Score the assessment and share the results with the student to increase understanding of his or her strengths and areas for improvement.
Collaborate with the certified special education teacher and the student to develop 2-3 interventions based on the student assessment data to support the student’s progress in the classroom. In addition, detail one intervention that can be incorporated at home with family support.
Use any remaining field experience hours to assist the teacher in providing instruction and support to the class.
Part 2: Reflection
In 250-500 words, summarize and reflect upon the following:
· Describe each intervention, including teacher, student, and family roles, where applicable.
· Your experiences administering the assessment, analyzing the results, and providing the student feedback on his or her performance.
· Explain how you expect the interventions you developed to meet the needs of the student, incorporating his or her assessment results in your response.
· Explain how you will use your findings in your future professional practice.
APA format is not required, but solid academic writing is expected.
This assignment uses a rubric. Review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
6
Annotated Bibliography
Student’s Name
Course
Instructor’s name.
Institutional Affiliation
October 7, 2021.
Annotated Bibliography
Ali, H., Ibrahem, S. Z., Al Mudaf, B., Al Fadalah, T., Jamal, D., & El-Jardali, F. (2018). Baseline assessment of patient safety culture in public hospitals in Kuwait. BMC Health Services Research, 18(1). https://doi.org/10.1186/s12913-018-2960-x
The researchers conducted a cross-sectional study in 16 public hospitals in Kuwait using the Hospital Survey on Patient Safety Culture (HSOPSC). The study aimed to assess patient safety culture in public hospitals as perceived by hospital staff and relate the findings similar to regional and international ...
This editorial discusses factors that affect patient safety during medical residency training. It notes that medical errors are a major threat to patient safety and can result from issues like inadequate supervision of trainees or procedures being performed beyond a doctor's abilities. While patient safety is important, the risks posed by resident fatigue, inadequate training, and communication breakdowns have only recently been recognized. The authors conducted a survey of residents to identify safety issues within their "sphere of influence" as educators, which will help guide educational interventions to address patient safety concerns.
Literature Evaluation TableStudent Name Vanessa NoaChange.docxmanningchassidy
Literature Evaluation Table
Student Name: Vanessa Noa
Change Topic (2-3 sentences): Patient safety is one of the pertinent issues in nursing home health care. The literature evaluation table summarizes the strength and relevance of eight peer-reviewed articles on the role of nurse education on fall prevention.
Criteria
Article 1
Article 2
Article 3
Article 4
Author, Journal (Peer-Reviewed), and
Permalink or Working Link to Access Article
Author: Howard Katrina
Journal: MEDSURG Nursing
https://www.thefreelibrary.com/Improving+Fall+Rates+Using+Bedside+Debriefings+and+Reflective+Emails%3A...-a0568974192
Authors: Jang and Lee
Journal: Educational Gerontology
Link: https://doi.org/10.1080/03601277.2015.1033219
Authors: Kuhlenschmidt et al.
Journal: Clinical Journal of Oncology Nursing
Link: https://doi.org/10.1188/16.CJON.84-89
Authors: Minnier et al.
Journal: Creative Nursing
Link: https://doi.org/10.1891/1078-4535.25.2.169
Article Title and Year Published
Title: Improving Fall Rates Using Bedside Debriefings and Reflective Emails: One Unit’s Success Story
Year: 2018
Title: The Effects of an Education Program on Home Renovation for Fall Prevention of Korean Older People
Year: 2015
Title: Tailoring Education to Perceived Fall Risk in Hospitalized Patients With Cancer: A Randomized, Controlled Trial
Year: 2016
Title: Four Smart Steps: Fall Prevention for Community-Dwelling Older Adults
Year: 2019
Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study
RQs: Why falls remain a challenging and complex problem
What innovative measures can reduce patient falls
Quantitative research
Aim/purpose: To discuss a project that seeks to implement innovative measures that help decrease patient falls
RQs: Does an education program on home renovation reduce falls among older people?
Quantitative study
Hypothesis: Appropriate education is crucial for fall prevention
Aim/Purpose: To verify the impacts of an education program on home renovation for preventing falls among older adults
RQs: Are there evidence-based interventions tailored to the perception of falls risk
Quantitative study
Aim/Purpose: To determine the effects of tailored, nurse-delivered interventions
RQs: Do guides for fall prevention enhance older adults’ knowledge and awareness of fall risks.
Quality improvement project
Aim/Purpose: To implement a simple, author-designed guide for fall prevention among older adults dwelling in the community
Design (Type of Quantitative, or Type of Qualitative)
Survey
Quasi-experimental
Randomized, controlled design
Narrative model
Setting/Sample
A team of clinical staff and leaders
51 participants
91 patient participants
Senior center
Methods: Intervention/Instruments
Open discussions to enable clinical staff to discuss concerns and provide feedback
In-depth interviews and survey
A two-group, controlled design. This design helped to test interventions in the bone marrow plantation unit
The prevention program dubbed Fou.
Exploring student perceptions of health and infection: an interactive staff a...Christopher Hancock
A portion of my classmates and I, were involved an extracurricular research activity involving a study on the perceptions of health and infection among the student population. We are very proud to announce that we have authored a paper as a result of the research.
Student Involvement in Quality & Safety at PritzkerVineet Arora
Presented at Association of American Medical Colleges Integrating QI meeting in Chicago IL Jun 2010 by Pritzker student Marcus Dahlstrom. Discusses IHI Open School, improvehealth.org and new quality and safety track at Pritzker.
The document summarizes a study conducted by the Florida Patient Safety Network on establishing a Patient Safety Authority in Florida. Key points:
- The study was mandated by the Florida legislature in response to Senate Bill 2-D from 2003 to evaluate creating a statewide Patient Safety Authority.
- The Authority would be responsible for activities and functions to improve patient safety and quality of care in health facilities and among practitioners.
- The study examined options for the Authority to directly perform safety functions, or contract with or partner with university patient safety centers.
- The Network coordinated its efforts with various stakeholders and academic medical centers across the state to conduct a comprehensive review and provide recommendations.
Communication failures in clinical settings have been identified as a leading cause of adverse events. While each health profession values patient-centered care, differences in values, norms and practices across professions can lead to conflicts and failures. Long Island University has implemented interprofessional education (IPE) initiatives to improve understanding and collaboration among health professions students from various programs. Evaluations found that IPE events increased students' understanding of different professional cultures, roles, responsibilities, and the importance of communication and teamwork. The university aims to expand IPE opportunities to further integrate interprofessional competencies into their curricula.
This document summarizes a partnership between the Mayo Clinic's simulation center and the University of North Florida's engineering school. Engineering students work on projects proposed by healthcare providers to develop medical devices, gaining course credit. Students are assigned to teams to design, build, and test prototypes like ultrasound trainers, cricothyrotomy trainers, and chest compression simulators. The partnership provides a way for students to apply their skills and for innovative solutions to issues in healthcare and training to be developed.
Texila American University is a top international medical university accredited by WHO and several standard Accreditations for the quality in medical education at South America.
This document discusses the need for increased patient safety in the U.S. healthcare system. It notes that medical errors have increased significantly in recent decades. While suggestions have been made to improve policies, procedures, and oversight, leadership within individual organizations will be key to implementing new patient safety protocols. Research is also needed to better understand errors and develop solutions. A focus on leadership, data, education, and continuous improvement can help healthcare organizations strengthen patient safety standards over time.
Chapter 2. Quality & Safety Education for Nurses.pdfAhmad Al-Sadi
The document discusses the Quality and Safety Education for Nurses (QSEN) initiative which aims to prepare nurses with the knowledge, skills, and attitudes needed to improve quality and safety in healthcare. It outlines the 6 QSEN competencies - patient-centered care, quality improvement, safety, teamwork and collaboration, evidence-based practice, and informatics. The document then details the 3 phases of QSEN's development and implementation in nursing education programs across the US. It provides examples of how the competencies have been integrated into nursing curricula.
This document reviews the literature on patient safety culture in hospitals. It identifies 7 key subcultures that define safety culture: leadership, teamwork, evidence-based practice, communication, learning, justice, and patient-centered care. Leadership is seen as essential for establishing a culture of safety. The review develops a conceptual model and typology that categorizes properties of each subculture identified in the literature. The model and typology are intended to help hospital leaders understand and develop an organizational culture of safety.
Similar to Designingpsundergraduatemedicalcurriculum(1) (20)
Pediatric heart failure can be life-threatening and lead to frequent readmissions. The article discusses the complex factors that contribute to high readmission rates for children with heart failure, including lack of care coordination and continuity. It recommends 10 strategies to improve communication during care transitions and reduce readmissions, such as creating common metrics to track outcomes, recognizing this as a complex adaptive challenge, and engaging clinicians in leadership and redesigning care processes. The goal is to improve outcomes and reduce costs through more coordinated, patient-centered care for this vulnerable population.
This document summarizes a study that assessed current practices in teaching life support competencies in healthcare. The study conducted surveys to: 1) Identify life support courses provided in UK hospitals and required by professional bodies, 2) Describe curriculum content and teaching methods of popular in-hospital courses, 3) Examine fidelity of implementation of courses in England. The study found that most NHS hospitals provide adult life support courses, with the Resuscitation Council UK Advanced Life Support course most common. Many hospitals also provide in-house courses. Recognition and management of pre-arrest deterioration are now widely taught. While life support training is provided in all medical schools, approaches vary and pre-arrest management courses are less common. Only a
This document provides a summary of a human factors analysis conducted of the Pediatric Blood & Marrow Transplantation Unit (PBMTU) at Duke University Hospital. The analysis was conducted over several months in late 2006 and early 2007 by a multi-disciplinary team from Aptima, Inc. The team conducted over 50 interviews and observations to identify stress points and potential failures within the PBMTU system. The analysis utilized several human factors techniques including interviews, observations, modeling, and assessment of the clinical microsystem framework. The report details the assessments and provides recommendations in each area of the framework to improve safety, quality of care, staff retention and the unit's ability to serve more patients.
This section discusses team training research and makes recommendations for improving team training in medical contexts. It summarizes that while some team training programs for healthcare professionals have shown promise, such as Anesthesia Crisis Resource Management (ACRM) training and MedTeams training, the evidence supporting their effectiveness in enhancing patient safety is still limited. It recommends developing a theoretical model of medical team performance, continuing to learn from the broader science of team performance and training, identifying core competencies for effective medical teamwork through consensus, and leveraging proven instructional strategies from team training research. The overall aim is to provide a strategy for further investigating how team training can help the medical community improve patient safety.
- Management interventions can be divided into targeted service interventions with narrow effects and generic service interventions that have diffuse effects like policy interventions.
- For targeted service interventions, measuring changes in clinical processes is often more cost-effective than measuring patient outcomes in evaluations.
- Clinical processes are not usually suitable primary endpoints for evaluations of policy and generic service interventions because their effects are too diffuse.
- Multiple clinical processes are consolidated into a small number of patient outcomes, which are the default primary endpoints for policy and generic service intervention evaluations.
- When a policy or generic service intervention is inexpensive and plausible effects on patient outcomes are difficult to detect, effects can still be studied at earlier process levels in Donabedian's causal chain model
This document describes a 9-step framework for evaluating the expected cost-effectiveness of a service intervention at the design stage. It applies this framework to evaluate an intervention to improve clinical handovers between hospital and community care.
The key steps are: 1) Identifying endpoints and grouping them, 2) Estimating baseline risks, 3) Eliciting expected effectiveness from experts, 4) Assigning utility values to endpoint groups, 5) Costing the intervention, 6) Estimating healthcare costs of adverse events, 7) Calculating health benefits, 8) Determining cost-effectiveness, and 9) Conducting sensitivity analysis.
When applied to a handover improvement intervention, literature suggested adverse events follow 19%
Three key themes emerged from the analysis of organizational culture aspects that impact hospital discharge: 1) A fragmented interface between hospitals and primary care with an inward focus on hospital care and lack of awareness of community needs; 2) Undervaluing of administrative discharge tasks compared to clinical work; and 3) A lack of reflection on discharge processes and opportunities for improvement. Nine categories further described barriers such as insufficient communication, task burdens, and negative attitudes. The study suggests organizational culture, including how hospital providers value discharge handovers and community outreach, is critical to effective transitions of care.
The document summarizes a systematic review of 36 randomized controlled trials that tested interventions to improve handovers of patients from hospitals to primary care. The majority (69.4%) of studies found statistically significant effects favoring the intervention, and most (94.4%) interventions were multicomponent. Effective interventions included medication reconciliation, electronic tools to facilitate discharge summaries, discharge planning involving both hospital and primary care providers, electronic discharge notifications, and Web-based access to discharge information for primary care physicians. The review found interventions often reduced hospital use, improved continuity of care, and enhanced patient status after discharge. However, the heterogeneity of interventions and outcomes made firm conclusions difficult to draw.
This document summarizes a research study that used the Intervention Mapping framework to develop a guiding framework for improving patient discharge from hospitals to primary care. The study conducted interviews and focus groups with patients, families, and providers to identify barriers to effective discharge. Key issues included lack of communication between hospital and primary care providers, incomplete discharge information, and lack of patient understanding. The study then defined desired outcomes, specific performance objectives, and change objectives needed to address the identified barriers. Finally, the study selected evidence-based methods and strategies to achieve the change objectives, such as discharge templates, medication reconciliation, and teach-back techniques. The resulting framework provides guidance for interventions to improve patient handovers between hospital and primary care.
This document is a business reply card from Jones & Bartlett Learning requesting a review copy of the book "Case Studies in Patient Safety: Foundations for Core Competencies". It provides instructions for qualified instructors to request a complimentary review copy for course adoption consideration by filling out their contact and course details on the pre-paid reply card or online. The book contains 24 first-person accounts of preventable health care errors told from the patient's perspective to illustrate lessons learned and strategies for preventing future errors.
- 15-year-old Lewis Blackman underwent elective surgery for pectus excavatum (sunken chest) at an academic medical center.
- In the days following surgery, Lewis experienced worsening abdominal pain but nurses dismissed it as constipation and insisted he walk more.
- His condition deteriorated over several hours but nurses were busy preparing for an inspection and did not take his worsening vital signs seriously.
- It was not until Lewis said "It's going black" that a cardiac code was called, but he could not be resuscitated and died 31 hours after reporting the abdominal pain.
This document discusses improving quality and safety in healthcare systems through an improvement science approach. It provides three key building blocks for developing a "high reliability organization":
1) Establishing a culture devoted to quality with trust, constructive error management, and zero tolerance for unsafe practices.
2) Implementing clear responsibility and accountability through defined care pathways, outcome measurement, and bottom-up process improvement.
3) Optimizing and standardizing processes through evidence-based standard operating procedures and scrutiny of variations.
Measurement of outcomes is also discussed as crucial for continuous improvement towards being "better than the rest." Engaging all levels is emphasized as fundamental to achieving reliable performance.
This document discusses the potential role of national health insurance in creating a safe, affordable, and high-quality healthcare system in the Bahamas. It begins by outlining the government's vision of transforming healthcare to be the safest and most effective in the region. It then discusses some of the current challenges in the Bahamian healthcare system, including a lack of coordination, increasing costs, and workforce issues. The document also reviews international healthcare system rankings and compares mortality rates between public and private patients in Bahamian hospitals. Overall, the document examines how a national health insurance system could help address issues in the current healthcare system and better serve the needs of Bahamians.
Yes, we're ready to go on bypass.
Perfusionist: Yes, I'm ready for bypass.
Surgeon: Okay, let's go on bypass.
Hospital B
Surgeon: Heparin please.
Anaesthetist: Heparin going in now. *administers heparin*
Perfusionist: Heparin level is therapeutic, I'm ready for bypass.
Surgeon: Okay, let's go on bypass.
Learning: Explicit verbal confirmation of key steps improves safety.
Catchpole K, 2011, in press
Human Factors in Healthcare
l Design of equipment, tasks, jobs, and environments
l Understanding human
More from Wayne State University School of Medicine (15)
1. PLEASE SCROLL DOWN FOR ARTICLE
This article was downloaded by: [UIC University of Illinois at Chicago]
On: 6 June 2011
Access details: Access Details: [subscription number 931141110]
Publisher Routledge
Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-
41 Mortimer Street, London W1T 3JH, UK
Teaching and Learning in Medicine
Publication details, including instructions for authors and subscription information:
http://www.informaworld.com/smpp/title~content=t775648180
Designing a Patient Safety Undergraduate Medical Curriculum: The
Telluride Interdisciplinary Roundtable Experience
David Mayera
; Debra L. Klamenb
; Anne Gundersonc
; Paul Barachd
a
Institute for Patient Safety Excellence, University of Illinois at Chicago College of Medicine, Chicago,
Illinois, USA b
Office of Education and Curriculum and Department of Medical Education, Southern
Illinois University School of Medicine, Springfield, Illinois, USA c
Undergraduate Medical Education
and Interprofessional Patient Safety Education and Research, University of Illinois at Chicago,
Chicago, Illinois, USA d
Anesthesiology, University of South Florida, Tampa, Florida, USA
To cite this Article Mayer, David , Klamen, Debra L. , Gunderson, Anne and Barach, Paul(2009) 'Designing a Patient
Safety Undergraduate Medical Curriculum: The Telluride Interdisciplinary Roundtable Experience', Teaching and
Learning in Medicine, 21: 1, 52 — 58
To link to this Article: DOI: 10.1080/10401330802574090
URL: http://dx.doi.org/10.1080/10401330802574090
Full terms and conditions of use: http://www.informaworld.com/terms-and-conditions-of-access.pdf
This article may be used for research, teaching and private study purposes. Any substantial or
systematic reproduction, re-distribution, re-selling, loan or sub-licensing, systematic supply or
distribution in any form to anyone is expressly forbidden.
The publisher does not give any warranty express or implied or make any representation that the contents
will be complete or accurate or up to date. The accuracy of any instructions, formulae and drug doses
should be independently verified with primary sources. The publisher shall not be liable for any loss,
actions, claims, proceedings, demand or costs or damages whatsoever or howsoever caused arising directly
or indirectly in connection with or arising out of the use of this material.
3. DESIGNING PATIENT SAFETY CURRICULUM 53
process of continuous quality improvement.”4
However, seri-
ous discussions on the design, implementation, assessment, and
faculty development needs of patient safety education in under-
graduate medical education have been sparse. Although patient
safety has been increasingly recognized as a key dimension of
quality care, there are few published reports addressing the de-
sign, implementation, and assessment of undergraduate patient
safety education. These include introductory workshops in pa-
tient safety,5–8
Crisis Resource Management education based
on lessons learned in the aviation industry,9
calls for safe medi-
cation prescribing10–12
continuous quality improvement,13
and
case-based learning opportunities.14
Nursing faculty have begun
to address patient safety education for new nurses through the
Quality and Safety Education for Nurses initiative (http://www.
qsen.org/). However, considerable effort in areas of patient
safety education is still needed to meet the calls for curricu-
lar redesign.
STRUCTURE OF THE ROUNDTABLE MEETING
Identifying and implementing a curriculum that instills the
necessary knowledge, skills, and attitudes related to patient
safety is challenging to undergraduate medical education. Med-
ical educators from the University of Illinois at Chicago
organized an annual invitational roundtable titled “Design-
ing a Patient Safety and Quality Outcomes Health Science
Curriculum” under the auspices of the Telluride Scientific
Research Conference and the Smithsonian Institute (http://www.
telluridescience.org/). The roundtable is supported by educa-
tional grants from the University of Illinois at Chicago Col-
lege of Medicine and Southern Illinois University School of
Medicine. Two roundtables were held in the summers of 2005
and 2006. Members of the roundtables included stakeholders
from the fields of nursing, pharmacy, medicine, public health,
and law, as well as senior health care administration, students,
residents, and patient advocacy leaders. Content experts in-
cluded those in medical education, curriculum innovation, fac-
ulty development, error science, simulator science, quality care,
informatics, risk management, law, and accreditation. (See end
of article for a complete list of attendees, their job titles, and
what year(s) they attended the conference.)
Stakeholders and content experts began to develop a struc-
tural framework for a patient safety curriculum through con-
versations and communications prior to the roundtable. The
roundtable participants met for 4 days in August 2005 and
again in August 2006 in Telluride, Colorado, to begin a de-
liberative inquiry process into the design of an interdisciplinary
patient safety curriculum. There was considerable overlap in
attendees for 2005 and 2006, though the groups were not iden-
tical. Roundtable activities included discussions of the current
literature, identification of appropriate educational methodolo-
gies, and recommendations on the design of a patient safety
curriculum as outlined in this article.
OUTCOMES OF THE ROUNDTABLE MEETINGS
The roundtable discussions have to date yielded three main
outcomes that need to be addressed in a new undergraduate
curriculum on patient safety.
Seeing Health Care (and Health Care Education) Through
a Different Lens
To be successful, a patient safety curriculum will require
a qualitative culture shift in the way students and educators
think about health care education. Health care education, as
it currently exists, is focused on an individual’s performance
and assessment of that performance. The educational system
is also silo based—for example, very little interprofessional or
team education occurs. Education, like hospital care, is orga-
nized around specific functions; medical students learn to write
prescriptions, pharmacy students learn to issue the medication,
and nursing students learn to deliver it to patients. Not much
attention, however, is paid to the systems needed to link all
these functions, and the health care students, into a coherent,
integrated, and safe system. In addition, the recognition of the
system as a source of error is generally not addressed in the
training of students. Instead, students are trained to individu-
ally meet their patients’ immediate needs while working around
recurrent system problems, ambiguities, and inefficiencies.
An example of an interdisciplinary systems approach to
reducing medical error may be illustrative to highlight the
difference in seeing health care through this different lens, a
necessary shift if a patient safety curriculum is to be successful.
The Center for Disease Control estimates that sepsis arising
from the insertion of a central venous line affects up to 250,000
patients a year in the United States, killing 15% or more.15
In
an individual silo-based approach to this problem, physicians
might receive additional training as to how to insert the line
more safely, using simulators and other advanced technology.
Beyond that, occasional sepsis arising from central venous line
insertion might be considered an unavoidable consequence
of an invasive procedure. If the health care team approached
the problem from a microsystems perspective, however, other
potential solutions might be considered:16
using transparent
dressings to improve the visibility of the wound to caregivers;
asking a nurse to supervise every insertion of a central line,
watching for lapses in sterile technique, and stopping the
procedure if such a lapse is seen; and avoiding femoral lines
if possible because of increased infection risk. These and
other countermeasures have been instituted in a few hospitals
already utilizing systems perspective and root cause analysis
approaches, with resulting decreases in infections by as much
as 87%.15
The point, however, is that if health care professionals
in these hospitals had been looking at this problem from a
silo-based perspective only, these risk reduction countermea-
sures would never have been conceived, let alone implemented.
Medical students need to be aware from the beginning of their
training that health care occurs within a system and that they
are part of that system, to see medicine through a different lens.
DownloadedBy:[UICUniversityofIllinoisatChicago]At:16:266June2011
4. 54 D. MAYER ET AL.
General Curricular Principles in a Patient Safety
Curriculum
Interprofessional education. Roundtable participants
emphasized that interprofessional education should be a
cornerstone of curricula for health science students and that
interprofessional education should be introduced early in the
educational process. The participants recognized the growing
body of work focused on interprofessional education at the
student level. Notable efforts include the Institute for Healthcare
Improvement Healthcare Professionals Education Collaborative
(http://www.ihi.org/IHI/Topics/HealthProfessionsEducation/);
the Robert Wood Johnson Foundation Partnership for Quality
Education initiative (http://www.pqe.org/); and the IOM’s
report titled “Health Professions Education: A Bridge to
Quality,”17
which called for education and assessment of
health student competency in interprofessional teamwork.
Effective interprofessional teamwork is known to reduce errors
caused by miscommunication and poor patient care handover.18
Grumback and Bodenheimer concluded that research on patient
care teams suggests that cohesive teams where physicians and
other health care professionals work together are associated
with improved patient outcomes.19
Improved teamwork skills
and greater collaboration between professions have been linked
with safe and effective health care.20
Students need to be aware
of these outcome improvements. In addition, students need to
both understand and experience firsthand the fact that “interpro-
fessional learning consists of more than just sharing the same
learning environment: it involves acquiring an understanding of
the knowledge base, values and ethos of like-minded individuals
and developing respect for each others’ contribution to the learn-
ing process”21
(p. 147). We cannot expect that students educated
in the current silo model of training will be able to effectively
work in interprofessional teams once they have finished their
training.
Longitudinal curricular approach. Roundtable members
believe that longitudinal approaches must be employed in pa-
tient safety education at the undergraduate level. Practicing and
reinforcing safety skills at each level are key elements in effec-
tive learning. The Dreyfus educational model has been used to
describe five longitudinal stages in the development of knowl-
edge and skills of pilots.22
Similar developmental processes
have been seen in chess players, adults learning a second lan-
guage, and adults learning to drive an automobile.Batalden
defined medical education and physician development as a
continuum starting at the beginning of medical school and
continuing throughout a practitioner’s professional career and
argued that the Dreyfus learning model could be applied to med-
ical education.23
The first stage of the Dreyfus model (“novice
stage”) is where basic concepts, skills and values are learned. For
clinical skills, Batalden noted, “this is where the beginning stu-
dent starts learning how to take a medical history through memo-
rization of the chief complaint, history of present illness, review
of systems and family and social history.” In the second stage,
known as the advanced beginner stage, students begin to exper-
iment with limited applications. It is in this second stage that
the third year medical student begins to appreciate common situa-
tions such as those facing hospitalized patients (admissions, rounds,
discharge) that can only be learned through experience.
The remaining three stages continue through residency and mid-
career, where the recognition of patterns and the use of intuition
are the major work drivers.
In similar fashion, a basic understanding of the concepts
and values of patient safety should be introduced early in the
curriculum, preferably in the first 2 years, followed by the super-
vised experimentation and application of these concepts during
clinical clerkships and on into graduate education.
Advanced patient safety educational opportunities for senior
students. Roundtable participants agreed that students seeking
further knowledge in patient safety should have access to more
intensive educational opportunities as electives. Further train-
ing in advanced competencies could help interested students
develop into leaders, researchers, and scholars in the patient
safety field.
Teaching methodologies. There are a number of different
strategies and educational modalities that roundtable partici-
pants thought should be utilized in addressing patient safety
education at the undergraduate level. These include plenaries,
small-group learning sessions, experiential learning, simulation,
standardized patient role-plays, case-based learning, individual
and team-based learning, and supportive audio-visual material.
Deliberate practice, a regimen of effortful activities coupled
with immediate feedback, designed to optimize improvement,
is the key to effective learning and retention of patient safety
information, as well as the requisite skills and attitudes.24
Assessment strategies. Roundtable participants stressed
that health profession students will need to be assessed in their
abilities as team members, not just individually, in a successful
patient safety curriculum. Their abilities to see systems-based
problems and inefficiencies and to offer systemic solutions
through root cause analyses will also need to be assessed.
These skills are not easily acquired but are nonetheless critical
to enable optimal performance in a health care environment
focused on patient safety. Assessment strategies that could
be used include the use of multiple choice questions for
patient safety knowledge, team-based assessment of groups
of interprofessional students as they work through a clinical
scenario, standardized patient assessment of full disclosure
skills, and the evaluation of student quality improvement
projects undertaken in the 3rd year of medical school.
Specific Content for a Patient Safety Curriculum
Roundtable participants agreed on 11 specific elements of
curriculum content that they believe are essential for an ef-
fective patient safety curriculum at the undergraduate medical
education level.
History of the medical error crisis. Students learning about
the scope and history of the medical error crisis will create a
DownloadedBy:[UICUniversityofIllinoisatChicago]At:16:266June2011
5. DESIGNING PATIENT SAFETY CURRICULUM 55
need to know and a call to action on the part of these future
health care professionals. The knowledge of the IOM’s 1999
report2
alone with an estimated 98,000 deaths per year due to
medical errors will be an eye-opener to students, who otherwise
are buried in learning basic science, diagnosis, and treatment
and have been unaware of the crisis. A need to know in the
area of patient safety will move this topic up on the students’
overcrowded attention list. Students should be exposed to this
material early in the 1st year of medical school.
Interdisciplinary teamwork skills. As discussed, these
skills are critical to the success of any patient safety initiative
and are very much absent in today’s undergraduate medical ed-
ucation curricula. Issues such as role clarity, conflict resolution,
chain of command, and the rehearsal of teams to provide care
in specific situations (such as acute trauma or codes) all need
to be addressed.25
Students should learn about their and other
health care provider roles in the system early in their 1st year
of medical school. Subsequently, in the 2nd year, once students
are acclimated to medical school and beginning to think about
working in clinical settings, topics such as hierarchy, chain-
of-command, team-based care, and leadership skills can be
introduced.
Time and stress management. The ability to manage one’s
time and stress, recognize when another health care team mem-
ber is stressed and thus less effective, or recognize when an
entire team is dysfunctional because of stress-related compli-
cations is well documented in safety literature as critical to
continued optimal performance.26
These skills (managing one’s
own time and stress) ought to be introduced to students early
in their 1st year and should be repeated on at least a yearly
basis as a refresher. More sophisticated skills such as recog-
nizing when another health care team member, or indeed the
entire team is stressed, should be introduced once students are
routinely working with these health care team members in the
3rd year.
Health care microsystems. Education in this arena is im-
portant to help students see the health care system through a
new lens, no longer a silo-based approach to health care. Un-
derstanding that health care professionals all work in multiple
microsystems and being effective in doing so as part of a larger
whole are key competencies in patient safety.27
This important
topic should be introduced to students in their 1st year of medical
school, and lends itself to introduction during interprofessional
training.
Informatics, electronic medical records, and health care tech-
nology. A working knowledge of these new developments in
health care will allow students to interact with them and under-
stand their importance in the provision of patient care. Students
should be introduced to these concepts in either the 1st or 2nd
year, well before they must actually interact with these systems
in the 3rd year.
Error science, error management, and human factor science.
An overview of how medical errors occur, how humans make
mistakes, environmental factors predisposing medical errors,
and principles of how to eliminate the errors from health care
systems will begin to equip students to deal with these issues in
their professional lives. This material would best be introduced
in the 2nd year of medical school as students learn other behav-
ioral science material, and in preparation for their entrance to
the clerkships in the 3rd year of medical school, where they will
see errors in health care systems in action and must therefore be
prepared to begin to understand them.
Communication skills. Although there is communication
skills training in undergraduate medical education curricula cur-
rently, a particular focus on errors in communication and how
these might be avoided is lacking. Patient safety communica-
tion content needs to focus on written skills such as order and
prescription writing, as well as chart documentation, and oral
skills such as communication between members of the health
care team during tasks such as hand-offs and consults. These
skills are best introduced in the 2nd year of medical school, as
they must be in place by the time students begin their 3rd-year
clerkships.
Full-disclosure applications. Students need to be trained
in the techniques of full disclosure to patients once an error has
occurred. Attitudes need to be formed early in students that the
admission of mistakes and the ability to say “I don’t know”
are valued, as these attitudes will allow the culture of medicine
to shift to one of patient safety and continuous learning from
mistakes.28
Students should be introduced to the concept of full
disclosure in the 2nd year of medical school and allowed to
practice this skill with standardized patients using simulated
clinical scenarios.
Risk management and root cause analysis. Risks and haz-
ards embedded within the structure and process of care have the
potential for causing injury and/or harm to patients. Accurate
identification of the root causes of events must precede identi-
fication and implementation of appropriate interventions. The
use of risk assessment techniques including process mapping
and failure modes and effects analysis can be used to identify
at which point interventions are most appropriate. This infor-
mation is essential to give health care providers the tools to
address problems in patient safety in a systematic, organized,
and methodical manner.29
It is probably sufficient to introduce
students to the concept that there are such tools available late in
their 2nd year as part of their quality improvement training. The
actual use of these tools might be implemented into the quality
improvement projects assigned to students in their 3rd and/or
4th years.
Outcome measures and continuous quality improvement.
Teaching students to monitor outcome measures and to crit-
ically examine failures in the system as soon as they occur
will lead to improved quality of care.30,31
Health care providers
trained in this model will more rapidly address failures in sys-
tems, rather than continuing workarounds that are demonstrat-
ing themselves to be noneffective. Lessons from industry—in
particular, Toyota—can be used in health care and health care
education to this end.32
Students should learn about issues of
DownloadedBy:[UICUniversityofIllinoisatChicago]At:16:266June2011
6. 56 D. MAYER ET AL.
continuous quality improvement late in their 2nd year of medi-
cal school, through the use of clinically based examples, which
will allow them to actively practice these kinds of skills. Later,
in the 3rd and 4th years of medical school, students should be
given continuous quality improvement projects, which will al-
low them to put their knowledge to work in real clinical settings.
Medication errors and reconciliation. Students should be
proficient in the recognition and prevention of medication errors
and reconciliation, as errors are frequent, often systems based,
and amenable to effective countermeasures if examined with a
patient safety lens. The clerkship year seems the reasonable time
to introduce this subject, as students are in the clinical setting. As
such, there will be ample opportunity to practice the recognition
of medication errors and to begin to learn techniques for their
reconciliation.
Barriers to Implementation
Roundtable participants identified a number of challenges
in implementing an undergraduate medical education patient
safety curriculum. First, many physicians and educators serving
as instructors, mentors, and role models have limited knowl-
edge and experience with the competencies required, because
the current medical–legal environment still favors hiding errors
and near-misses instead of learning from them. Indeed, most
physicians believe they provide safe patient care and do not
make mistakes. In a survey given to more than 1,000 doctors,
nurses, and residents in urban teaching and nonteaching hospi-
tals, one third of intensive care staff stated that they have never
made an error.33
However, only one third reported that errors are
handled appropriately, and more than half reported that they find
it difficult to discuss mistakes. It is clear that rather extensive fac-
ulty development will be needed for a successful patient safety
curriculum to be implemented. Second, educational models are
predominantly driven by individual, silo-based performance on
examinations that preferentially reward memorization and recall
of knowledge over application. Kenneth Shine, past-president
of the IOM, concluded that medicine has failed to deliver qual-
ity care to patients, because medicine equates quality with how
much an individual physician knows instead of looking at qual-
ity as how well patients are cared for.34
Changing assessment
strategies to look at interprofessional cooperation and problem
solving will require new methodologies to be developed and im-
plemented, a significant time- and money-consuming endeavor.
Assessment strategies will also need to be modified to reflect the
importance of patient safety education and outcomes. A recent
article by Kachalia et al. reported on the efforts of an expert
panel convened by the American Board of Medical Specialties
to look into the types of patient safety questions that should
be included in medical board certification examinations, which
is encouraging.35
Third, and not inconsequential, will be the
struggle to carve out the time and commitment necessary for
a successful, longitudinal, patient safety curriculum from an
already full curriculum.
SUMMARY AND NEXT STEPS
The goal of a medical education curriculum is to teach stu-
dents to address problems that affect the health of the public, and
patient safety is a concern in the provision of quality health care
that needs to be addressed immediately. Students need to un-
derstand, appreciate, and demonstrate appropriate patient safety
skills early and continuously in their professional educations.
Roundtable participants met for four days each in the summers
of 2005 and 2006 in Telluride, Colorado, to discuss the curric-
ular design of an interdisciplinary patient safety curriculum. If
we are to change the current culture, it is important that students
begin to understand, appreciate, and demonstrate appropriate
skills relative to the prevention of medical error early in their
professional education. Tremendous opportunity exists to pro-
foundly influence the safety of health care delivery by changing
the educational environment, teaching methods, and health pro-
fessional curricula. Although progress has been made, much
more is left to be done. Future meetings of roundtable partici-
pants in Telluride are slated to occur, in which curricular pilots
implemented throughout the year will be discussed; refined;
and, if successful, adopted by others. New curricular opportu-
nities will continue to be discussed and designed. Through this
continued dialogue and ongoing collaborative research, the de-
velopment and implementation of a longitudinal patient safety
curriculum will occur.
REFERENCES
1. Kern DE, Thomas PA, Howard DM, Bass EB. Curriculum development for
medical education: a six-step approach. Baltimore: Johns Hopkins Univer-
sity Press, 1998.
2. Kohn LT, Corrigan JM, Donaldson MS (Eds.). To err is human: Building a
safer health system. Washington, DC: National Academy Press, 2000.
3. Committee on Quality of Health Care in America, Institute of Medicine.
Crossing the quality chasm: A new health system for the 21st century.
Washington, DC: National Academy Press, 2001.
4. Cohen J. Letter to medical school deans. Washington, DC: Association of
American Medical Colleges, December 1999.
5. Halbach JL, Sullivan LL. Teaching medical students about medical errors
and patient safety: Evaluation of a required curriculum. Academic Medicine
2005;80:600–6.
6. Ogrinc G, Headrick LA, Mutha S, Coleman MT, O’Donnell J, Miles PV. A
framework for teaching medical students and residents about practice-based
learning and improvement, synthesized from a literature review. Academic
Medicine 2003;78:748–56.
7. Madigosky W, Headrick L, Nelson K, Cox K, Anderson T. Changing and
sustaining medical students’ knowledge, skills, and attitudes about patient
safety and medical fallibility. Academic Medicine 2006;81:94–101.
8. Whisnant R. Medical schools teach safety. Minn Med. 2005;87(4):9.
9. Flanagan B, Nestel D, Joseph M. Making patient safety the focus: Crisis
resource management in the undergraduate curriculum. Medical Education
2004;38(1):56–66.
10. Boreham NC, Mawer GE, Foster RW. Medical students’ errors in pharma-
cotherapeutics. Medical Education 2000;34:188–93.
11. Dickey NW. Patient safety and medical education: Undergraduates must be
proficient in basic prescribing. British Medical Journal 2002;324:930–1.
12. Langford NJ, Martin U, Kendall MJ, Ferner RE. Medical schools can
teach safe drug prescribing and administration. British Medical Journal
2001;322:1424.
DownloadedBy:[UICUniversityofIllinoisatChicago]At:16:266June2011
7. DESIGNING PATIENT SAFETY CURRICULUM 57
13. Henley E. A quality improvement curriculum for medical students. Journal
of Quality Improvement 2002;28(1):42–8.
14. Seiden SC, Galvan C, Lamm R. Role of medical students in preventing
harm and enhancing patient safety. Quality and Safety in Health Care
2006;15:272–6.
15. Spear SJ. Fixing healthcare from the inside, today. Harvard Business Review
September 2005, pp. 78–91.
16. Barach P, Johnson J. Safety by design: Understanding the dynamic com-
plexity of redesigning care around the clinical microsystem. Quality and
Safety in Health Care 2006;15(Suppl 1):i10–6.
17. Institute of Medicine. Health professions education: A bridge to quality.
Washington, DC: National Academies Press, 2003.
18. Silver MP, Antonow JA. Reducing medication errors in hospitals: A peer
review organization collaboration. Joint Commission Journal Quality Im-
provement 2000;26:332–40.
19. Grumbach K, Bodenheimer T. Can healthcare teams improve pri-
mary care practice? Journal of the American Medical Association
2004;291(10):1246–51.
20. Wood DF. Interprofessional education: Still more questions than answers?
Medical Education 2001;35(9):816.
21. Glen S, Leiba T. Multiprofessional education for nurses: Breaking the
boundaries? Basingstoke, UK: Palgrave, 2001.
22. Dreyfus H, Dreyfus S. Mind over machine. New York: Free Press,
1986.
23. Batalden P, Leach D, Swing S, Dreyfus H, Dreyfus S. General competencies
and accreditation in graduate school medical education. Health Affairs
2001;5:103.
24. Ericsson KA. Attaining excellence through deliberate practice: Insights
from the study of expert performance. In M. Ferrari (Ed.), The pursuit of
excellence in education (pp. 21–55). Hillsdale, NJ: Erlbaum, 2002.
25. Baker D, Battles J, King H, Salas E, Barach P. The role of teamwork
in the professional education of physicians: Current status and assess-
ment recommendations. Joint Commission Journal on Quality and Safety
2005;31(4):185–202.
26. Sexton JB, Thomas EJ, Helmreich RL. Error, stress and teamwork in
medicine and aviation: Cross-sectional surveys. British Medical Journal
2000;320:745–9.
27. Mohr JJ, Batalden PB, Barach P. Inquiring into the quality and safety of
care in the academic clinical microsystem. In K McLaughlin & A Kaluzny
(Eds.), Continuous quality improvement in health care (3rd ed., pp. 407–
23). Frederick, MD: Aspen, 2005.
28. Cantor M, Barach P, Derse A, Maklan C, Woody G, Fox E. Disclosing
adverse events to patients. Joint Commission Journal on Quality and Safety
2005;31:5–12.
29. Apostolakis G, Barach P. Lessons learned from nuclear power. In M Hatlie
& K Tavill (Eds.), Patient safety, international textbook (pp. 205–25).
Frederick, MD: Aspen, 2003.
30. Vohra P, Daugherty C, Mohr J, Wen M, Barach P. Housestaff and medi-
cal student attitudes towards adverse medical events. JCAHO Journal of
Quality and Safety, 2007, in press.
31. Gould BE, Grey MR, Huntington CG. Improving patient care outcomes
by teaching quality improvement to medical students in community-based
practices. Academic Medicine 2002;77:1011–8.
32. Armstrong EG, Mackey M, Spear SJ. Medical education as a process man-
agement problem. Academic Medicine 2004;79(8):721–8.
33. Sexton JB, Thomas EJ, Helmreich RL. Error, stress and teamwork in
medicine and aviation: Cross-sectional surveys. British Medical Journal
2000;320:745–9.
34. Shine KI. Health care quality and how to achieve it. Academic Medicine
2002;77:91–9.
35. Kachalia A, Johnson J, Miller S, Brennan T. The incorporation of pa-
tient safety into board certifying exams. Academic Medicine 2006;81:317–
25.
LIST OF ROUNDTABLE PARTICIPANTS
Paul Barach, MD, MPH (2005, 2006)
Associate Professor of Anesthesiology
University of South Florida
John Bingham (2005)
Director, Center for Clinical Improvement
Vanderbilt University College of Medicine
Barbara Blakeney, MS, RN (2005)
Past President
American Nursing Association (ANA)
Lydia Cassorla, MD, MBA (2005)
Department of Anesthesiology
University of California at San Francisco Medical Center
Robert M. Galbraith, MD, MBA (2006)
Director for the Center of Innovation.
National Board of Medical Examiners
Anne Gunderson, GNP CRRN-A (2006)
Research Assistant Professor;
Department of Medical Education
University of Illinois Chicago College of Medicine
Pam Hagan, MSN, RN (2006)
Chief Program Officer
American Nursing Association
Helen Haskell (2005, 2006)
Founder and President of Mothers Against Medical Error
(MAME)
Russ Jenkins, MD (2005)
Medical Director
Institute for Safe Medication Practices (ISMP)
Julie K. Johnson (Mohr), M.S.P.H., Ph.D. (2006)
Assistant Professor of Medicine; University of Chicago
Medical Center
Director of Research for the American Board of Medical
Specialties
Debra L. Klamen, M.D., M.H.P.E, F.A. P.A. (2006)
Professor and Chair, Department of Medical Education;
Associate Dean for Education
Southern Illinois University School of Medicine
David Mayer, MD (2005, 2006)
Associate Dean for Curriculum; Co-director Institute for Patient
Safety Excellence
University of Illinois at Chicago College of Medicine
DownloadedBy:[UICUniversityofIllinoisatChicago]At:16:266June2011
8. 58 D. MAYER ET AL.
Tim McDonald, MD JD (2005, 2006)
Associate Chief Medical Officer for Safety, Risk Management
and Quality
Co-director Institute for Patient Safety Excellence
University of Illinois Medical Center at Chicago
Bonnie Miller, MD (2005)
Associate Dean for Undergraduate Medical Education
Vanderbilt University College of Medicine
Lou Oberndorf (2006)
Founder, President and Chief Executive Officer of
Medical Education Technologies, Inc. R
(METI R
)
Ingrid Philibert, MHA, MBA (2006)
Director, Department of Field Activities
Accreditation Council for Graduate Medical Education
(ACGME)
Doris C. Quinn, PhD (2006)
Director of Improvement Education in the Center for Clinical
Improvement
Vanderbilt University
Cary Sennett, MD (2005)
Senior Vice President for Research
American Board of Internal Medicine (ABIM)
Michael Seropian, MD, FRCPC (2006)
Associate Professor; Co-director OHSU Simulation and
Clinical Learning Center.
Oregon Health and Science University (OHSU)
Gwen D. Sherwood, PhD, RN, FAAN (2006)
Professor and Associate Dean for Academic Affairs
University of North Carolina at Chapel Hill School of Nursing
Kenichiro Taneda, MD, MPH (2005, 2006)
Senior Researcher of the Department of Policy Sciences
National Institute of Public Health, Japan
Ara Tekian, PhD MHPE (2006)
Director International Affairs; Department of Medical Educa-
tion
University of Illinois at Chicago College of Medicine
Scott Weber (2005)
President
Physicians Practice
Reed Williams, MD (2005, 2006)
Professor and Vice Chairman for Educational Affairs in the
Department of Surgery
Southern Illinois University School of Medicine
DownloadedBy:[UICUniversityofIllinoisatChicago]At:16:266June2011