Preparing Emergency Medicine Residents to Disclose Medical Error Using Standardized Patients (original) (raw)
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Korean Journal of Medical Education, 2022
Purpose: We aimed to develop a program for error disclosure for emergency medicine (EM) residents to determine its effects.Methods: Fifteen EM residents participated in 2020. The program included two-error disclosure sessions using standardized patients (SPs), a didactic lecture, and debriefing. The Kirkpatrick model was used to evaluate this program. Satisfaction scores and narrative reactions were collected (level 1). Residents were asked to choose their actions and explain reasons for the representative error cases before and after the program (level 2). After 2 months, they were asked to write their experiences of disclosing errors to real patients (level 3). The differences in the disclosing communication scores allocated by the SPs were compared between the senior and junior residents.Results: The residents’ satisfaction scores were high. Before the program, some residents chose not to disclose errors when there were no harmful sequelae at the time of the incident. After the p...
Western Journal of Emergency Medicine
Introduction: Feedback, particularly real-time feedback, is critical to resident education. The emergency medicine (EM) milestones were developed in 2012 to enhance resident assessment, and many programs use them to provide focused resident feedback. The purpose of this study was to evaluate EM residents' level of interest in receiving real-time feedback on each of the 23 competencies/sub-competencies. Methods: This was a multicenter cross-sectional study of EM residents. We surveyed participants on their level of interest in receiving real-time on-shift feedback on each of the 23 competencies/subcompetencies. Anonymous paper or computerized surveys were distributed to residents at three fouryear training programs and three three-year training programs with a total of 223 resident respondents. Residents rated their level of interest in each milestone on a six-point Likert-type response scale. We calculated average level of interest for each of the 23 sub-competencies, for all 223 respondents and separately by postgraduate year (PGY) levels of training. One-way analyses of variance were performed to determine if there were differences in ratings by level of training. Results: The overall survey response rate across all institutions was 82%. Emergency stabilization had the highest mean rating (5.47/6), while technology had the lowest rating (3.24/6). However, we observed no differences between levels of training on any of the 23 competencies/sub-competencies. Conclusion: Residents seem to ascribe much more value in receiving feedback on domains involving high-risk, challenging procedural skills as compared to low-risk technical and communication skills. Further studies are necessary to determine whether residents' perceived importance of competencies/ sub-competencies needs to be considered when developing an assessment or feedback program based on these 23 EM competencies/sub-competencies. [
Interdisciplinary Journal of Virtual Learning in Medical Sciences, 2016
Background: Commitment to evidence-based medicine (EBM) means the informed and fair use of the best evidence for accurate diagnosis and treatment decisions for patients. This approach attempts to improve the quality of clinical decision-making. The current study aimed to investigate the effects of EBM training courses on the theoretical knowledge and practical skills of clinical residents. Methods: A quantitative method based on a quasi-experimental single group design was used in this study. Two researcher-made questionnaires and one test were used as the major instruments for evaluating the satisfaction, knowledge and practical capabilities of participants. The content validity of the questionnaires was confirmed by five educational experts in medical education and clinical practices, and the reliability was calculated through Chronbach's alpha (r = 0.92 and 0.93). The questionnaires were distributed among all 110 junior clinical residents who participated in the EBM workshop; 62 residents completed the questionnaire. The gathered data was analyzed through SPSS version 14 using paired t-test and Pearson's correlation. Results: Participants took a high level of satisfaction (means of all items were higher than the cutoff points) from the evidencebased medical course. Participants' knowledge and practical abilities were significantly broadened as a result of attending the EBM course (P < 0.01). In addition, a positive significant correlation was found between the knowledge scores and practical ability scores of residents who participated in the EBM course (r = 84%). Conclusions: More emphasis needs to be placed on developing the practical skills of residents in the EBM course. It is also essential that clinical ward residents be required to make clinical decisions based on evidence-based medicine.
Pediatric Resident Education About Medical Errors
Ambulatory Pediatrics, 2004
Background.-National organizations have called for patient safety curricula to help reduce the incidence of errors. Little is known about what trainees are taught about medical errors.
Setting the Educational Agenda and Curriculum for Error Prevention in Emergency Medicine
Academic Emergency Medicine, 2000
Abstract. Graduate and postgraduate medical education currently teaches safety in patient care by instilling a deep sense of personal responsibility in student practitioners. To increase safety, medical education will have to begin to introduce new concepts from the “safety sciences,” without losing the advantages that the values of commitment and responsibility have gained. There are two related educational goals. First, we in emergency medicine (EM) must develop a group of safety-educated practitioners who can understand and implement safe practice innovations in their clinical settings, and will be instrumental in changing our professional culture. Second, EM must develop a group of teachers and researchers who can begin to deeply understand how safety is maintained in emergency care, develop solutions that will work in emergency department settings, and pass on those insights and innovations. The specifics of what should be taught are outlined briefly. Work is currently ongoing to identify more specifically the core content that should be included in educational programs on patient safety in emergency care. Finally, careful attention will have to be paid to the way in which these principles are taught. It seems unlikely that a series of readings and didactic lectures alone will be effective. The analysis of meaningful cases, perhaps supplemented by high-fidelity simulation, seems to hold promise for more successful education in patient safety.
Advances in medical education and practice, 2018
Non-medical knowledge-based sub-competencies (multitasking, professionalism, accountability, patient-centered communication, and team management) are challenging for a supervising emergency medicine (EM) physician to evaluate in real-time on shift while also managing a busy emergency department (ED). This study examines residents' perceptions of having a medical education specialist shadow and evaluate their nonmedical knowledge skills. Medical education specialists shadowed postgraduate year 1 and postgraduate year 2 EM residents during an ED shift once per academic year. In an attempt to increase meaningful feedback to the residents, these specialists evaluated resident performance in selected non-medical knowledge-based Accreditation Council of Graduate Medical Education (ACGME) sub-competencies and provided residents with direct, real-time feedback, followed by a written evaluation sent via email. Evaluations provided specific references to examples of behaviors observed dur...