Effectiveness of an interprofessional patient safety team-based learning simulation experience on healthcare professional trainees (original) (raw)
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Applying interprofessional Team-Based Learning in patient safety: a pilot evaluation study
BMC Medical Education
Background: Interprofessional education (IPE) interventions are not always successful in achieving learning outcomes. Team-Based Learning (TBL) would appear to be a suitable pedagogical method for IPE, as it focuses on team performance; however, little is known about interprofessional TBL as an instructional framework for patient safety. In this pilot-study, we aimed to (1) describe participants' reactions to TBL, (2) observe their achievement with respect to interprofessional education learning objectives, and (3) document their attitudinal shifts with regard to patient safety behaviours. Methods: We developed and implemented a three-day course for pre-qualifying, non-medical healthcare students to give instruction on non-technical skills related to 'learning from errors'. The course consisted of three sequential modules: 'Recognizing Errors', 'Analysing Errors', and 'Reporting Errors'. The evaluation took place within a quasi-experimental pre-test-post-test study design. Participants completed self-assessments through valid and reliable instruments such as the Mennenga's TBL Student Assessment Instrument and the University of the West of England's Interprofessional Questionnaire. The mean scores of the individual readiness assurance tests were compared with the scores of the group readiness assurance test in order to explore if students learned from each other during group discussions. Data was analysed using descriptive (i.e. mean, standard deviation), parametric (i.e. paired t-test), and non-parametric (i.e. Wilcoxon signed-rank test) methods. Results: Thirty-nine students from five different bachelor's programs attended the course. The participants positively rated TBL as an instructional approach. All teams outperformed the mean score of their individual members during the readiness assurance process. We observed significant improvements in 'communication and teamwork' and 'interprofessional learning' but not in 'interprofessional interaction' and 'interprofessional relationships.' Findings on safety attitudes and behaviours were mixed. Conclusion: TBL was well received by the students. Our first findings indicate that interprofessional TBL seems to be a promising pedagogical method to achieve patient safety learning objectives. It is crucial to develop relevant clinical cases that involve all professions. Further research with larger sample sizes (e.g. including medical students) and more rigorous study designs (e.g. pre-test post-test with a control group) is needed to confirm our preliminary findings.
MedEdPORTAL Publications, 2016
Introduction: Teaching and learning patient safety require demonstration of competencies such as teamwork, communication skills, and recognition of systems error. This patient safety TBL simulationtraining program was developed to fulfill core patient safety objectives outlined by the ACGME and ACGME Clinical Learning Environment Review Program. The goal of the program is to enhance patient safety and quality care concepts and facilitate hands-on teamwork skills and core attitudes towards patient safety. This program served as a mandatory part of the residency core curriculum. Methods: It was delivered as a 3-hour workshop session during medicine resident orientation. The workshop included an introductory presentation, one TBL activity, and three 1-hour interprofessional simulated application cases using either high-fidelity mannequins or standardized patients. Following each application case activity, trainees participated in a postcase scenario debriefing moderated by faculty facilitators. Results: A total of 76 trainees participated, and 20 interprofessional teams were created. An independent-samples t test revealed that the Group Readiness Assurance Test scores were significantly higher than the Individual Readiness Assurance Test scores. Although the Readiness for Interprofessional Learning Survey's Teamwork and Professional Identity subscale scores were higher postworkshop compared to preworkshop, the differences were not statistically significant. Over 90% of the participants agreed that the safety concepts they learned would likely improve the quality of care they provide to future patients. Discussion: A simulation model centered on an interprofessional team can be used as an important training technique to teach health care professionals realistic, hands-on principles of patient safety.
Sigma's 30th International Nursing Research Congress, 2019
Background: Healthcare educators are to prepare and graduate competent health care professionals who are able to provide safe patient and family-centered care (AACN, 2012). Educating health profession students about patient safety has been a priority since the publication of the "To Err Is Human" report in 1999. Traditionally, teaching health profession students about patient safety involves the use of case studies, simulation scenarios, and clinical activities. An innovative approach to develop and implement interprofessional education (IPE) activities that promote safety is to partner with patient advisors. Involving patients and their families as advisors helps healthcare professionals understand the patient side of healthcare, learn what really matters for the patients and their families, and promote patient engagement in creating a safe patient and familycentered care (AHRQ, 2017). The Institute for Healthcare Improvement (IHI) defines a patient advisor as "a person with lived experience as a patient or family member who is collaborating with a healthcare organization and shows success, drive, and interest in improving the patient experience" (McTiernan, 2017). Purpose: The purpose of this study is to develop and implement interprofessional education activities in partnership with patient advisors to teach patient safety, to promote awareness of the impact of medical errors on the patient, and to help students meet the Interprofessional Education Collaborative core competencies of roles/responsibilities, communication, and teamwork (IPEC, 2016, p. 10). Methods: In preparation for the IPE workshop, pharmacy and nursing students were required to complete two IHI Open School patient safety courses; PS 100: Introduction to Patient Safety and PS 101: Fundamentals of Patient Safety (IHI, 2016). On the workshop day, students were divided into four groups; each group had a mix of nursing and pharmacy students. The first activity was designed to help students learn about each other's roles and responsibilities. Each group was asked to draw a Venn diagram and write similarities and differences between their roles. The second activity involved two patient safety advisors, who were invited as guests to talk about their experience as patients and to share with the students the patient safety issues that they experienced. Following ▪ Utilization of an activity that promotes students' learning of each other's roles and responsibilities and promotes communication among team members. o Results ▪ Discuss the results of the study o List the impact of the study on education/practice o References
Improving Patient Safety: Engaging Students in Interprofessional Team-Based Learning (TBL)
Journal of university teaching and learning practice, 2023
Complex healthcare systems and ambiguous clinical decisions can result in medical errors which threaten patient safety. There is a need for improved awareness of medical errors across healthcare disciplines. We utilised team-based learning (TBL) to pilot an interprofessional patient safety module for senior health professional students. We evaluated the use of TBL within the interprofessional context to achieve student learning outcomes. Twenty-seven students from pharmacy (n=11), nursing (n=8) and medicine (n=8) faculties participated. Data were collected via questionnaires, focus groups, class observation and student test scores. Quantitative data were analysed using descriptive statistics. Framework analysis was used to code qualitative data using social capital as a conceptual framework. In total, 26/27 (96%) of participants completed the questionnaire and 20/27 (70%) attended focus groups. There was no significant difference in prior knowledge between the disciplines. The TBL module enriched the learning environment and enabled students to prepare, problem-solve and interact with facilitators. The TBL pedagogy and interprofessional framework enabled the development of social capital among students. The module demonstrated the potential of interprofessional education to shift knowledge and attitudes towards a greater appreciation of patient safety issues and better prepare health professional students for the workforce. The TBL pedagogy strengthened knowledge sharing and fostered collaboration across disciplines. Practitioner Notes Practitioner Notes 1. Dedicated interprofessional training at the university education level can improve patient safety. 2. The TBL framework enables student learning through preparation, practice, and problemsolving with intra-and inter-team discussion. 3. This patient safety module promoted interprofessional collaboration and examined existing roles, practices, and biases of other disciplines. 4. Social capital is used to describe and understand how individuals benefit from participating in a social network and offers a valuable lens to analyse educational methods. 5. When designing interprofessional case-based activities, care must be taken to ensure the clinical case is relevant to all disciplines.
Nurse Education in Practice, 2016
Poor teamwork is an important factor in the occurrence of critical incidents because of a lack of nontechnical skills. Team training can be a key to prevent these incidents. The purpose of this study was to explore the experience of nursing and medical students after a simulation-based interprofessional team training (SBITT) course and its impact on professional and patient safety practices, using a concurrent mixed-method design. The participants (n ¼ 262) were organized into 44 interprofessional teams. The results showed that two training sequences the same day improved overall team performance. Making mistakes during SBITT appeared to improve the quality of patient care once the students returned to clinical practice as it made the students more vigilant. Furthermore, the video-assisted oral debriefing provided an opportunity to strengthen interprofessional teamwork and share situational awareness. SBITT gave the students an opportunity to practice clinical reasoning skills and to share professional knowledge. The students conveyed the importance of learning to speak up to ensure safe patient practices. Simulated settings seem to be powerful arenas for learning patient safety practices and facilitating transference of this awareness to clinical practice.
Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine, 2011
This report reviews and critically evaluates the development of 3 movements in healthcare that have had a profound impact on changes occurring at all levels of medical education: patient safety, healthcare simulation, and competency-based education (exemplified by the Accreditation Council for Graduate Medical Education). The authors performed a critical and selective review of the literature from 1999 to 2011 to identify uses of simulation to address patient-safety issues aligned according to the Accreditation Council for Graduate Medical Education 6 core competencies: (1) patient care; (2) medical knowledge; (3) interpersonal and communication skills; (4) professionalism; (5) practice-based learning; and (6) systems-based practice. The research synthesis is reported to inform and provide evidence about how simulation is used to train and evaluate learners on a range of patient-safety issues for each of the core competencies: There is emerging evidence that simulation can be used in training efforts to reduce medical errors related to medical knowledge and patient care (particular invasive procedures as well as improved communication and teamwork skills). There remains limited evidence on its impact to improve patient safety related to more complex competencies of practice-based learning and systemsbased practice. Simulation-based learning can lead to positive patient outcomes and reduction of medical errors particularly when used for individual skills. However, particular attention needs to be placed on the organizational context in which it is implemented if improvements in practice-based learning and systems-based practice are to be realized. Mt Sinai J Med 78:842-853, 2011.
Interprofessional education in team communication: Working together to improve patient safety
2013
Background Communication failures in healthcare teams are associated with medical errors and negative health outcomes. These findings have increased emphasis on training future health professionals to work effectively within teams. The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) communication training model, widely employed to train healthcare teams, has been less commonly used to train student interprofessional teams. The present study reports the effectiveness of a simulation-based interprofessional TeamSTEPPS training in impacting student attitudes, knowledge and skills around interprofessional communication.
Training a Patient Safety Work Force: The Patient Safety Improvement Corps
Health Services Research, 2009
Objective. Evaluate short-term effects of the Patient Safety Improvement Corps (PSIC), an Agency for Healthcare Research and Quality–sponsored program to train state teams in patient safety skills/tools, to assess its contribution to building a national infrastructure supporting effective patient safety practices.Data Source. Self-reported information gathered from (1) group interviews at the end of each year; (2) individual telephone interviews 1 year later; (3) faxed information forms 2 years later.Study Design. Program evaluation of immediate and short-term process and impact (use of skills/tools, information sharing, changes in practice).Data Collection. Semistructured interviews; faxed forms.Principal Findings. One year after training, approximately half of Year 1 and 2 state agency representatives reported they had initiated or modified legislation to strengthen safe practices, and modified adverse event oversight procedures. Approximately three-quarters of hospital representatives said training contributed to modifications to adverse event oversight procedures and promotion of patient safety culture. Two years posttraining, approximately three-quarters of Year 1 trainees said they continued to use many skills/tools.Conclusions. The PSIC contributed to building a national infrastructure supporting effective patient safety practices. Expanded training is needed to reach a larger fraction of the population for which this training is important.
Medical Teacher, 2013
Background: Training in patient safety is an important element of medical education. Most educational interventions on patient safety training adopt a 'health-professional lens' with limited consideration on the impact of safety lapses on the patient and their families and little or no involvement of patients in the design or delivery of the training. Aims: This paper describes a pilot study to test the feasibility and acceptability of implementing a patient-led educational intervention to facilitate safety training amongst newly qualified doctors. Method: Patients and/or carers who had experienced harm during their care shared narratives of their stories with trainees; this was followed by a focused discussion on patient safety issues exploring the causes and consequences of safety incidents and lessons to be learned from these. Results: The intervention, which will be further tested in an NIHR-funded randomised controlled trial (RCT), was successfully implemented into an existing training programme and found acceptance amongst the patients and trainees. Conclusion: The pilot study proved to be a useful step in refining the intervention for the RCT including identifying appropriate outcome measures and highlighting organisational issues.