Online patient safety education programme for junior doctors: is it worthwhile?

Background Because residents are often on the frontlines of patient care and are likely to witness adverse events firsthand, it is critical they report patient safety events. They may, however, be underreporting. Objective We examined the current literature to identify strategies to increase patient safety event reporting by residents. Methods We used CINAHL (EBSCO Information Services, Ipswich, MA), EMBASE (Elsevier, Amsterdam, the Netherlands), PsycINFO (APA Publishing, Washington, DC), and PubMed (National Center for Biotechnology Information, Bethesda, MD) databases. The search was limited to English-language articles published in peer-reviewed journals through March 2020. Key terms included “residents, trainees, fellows, interns, graduate medical education, house staff, event reporting, patient safety reporting, incident reporting, adverse event, and medical error.” To organize findings, we adapted a published framework of strategies for encouraging self-protective behavior. Results We identified 68 articles that described strategies used to increase event reporting. The most sustainable interventions used a combination of 3 of the 5 strategies: behavior modeling, surveys and messaging, and required limited financial support. The survey creates awareness; the behavior modeling is critical for educational purposes, and the reminders help to reinforce the new behavior and embed it into routine patient care activities. We noted a dearth of studies involving trainees in root cause analysis following submission of event reports. Conclusions The most successful sustainable interventions were those that combined strategies that minimized time for busy physicians, incorporated accessible event reporting in already existing medical records, and became part of a normal workflow in patient care.

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“…References 6,9,11,12,[14][15][16]18,19,21,22,24,30, 41-44, 47-68. †References 6, 18, 44, 51, 56, 57, 62, 69-72.…”

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confidence: 99%

A Narrative Review of Strategies to Increase Patient Safety Event Reporting by Residents

Aaron

Webb

Luhanga

2020

Journal of Graduate Medical Education

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“…Knowledge on hereditary cancer and comprehension of communication skills showed significant improvement. Studies aimed at health professionals investigating the effect of e-learning modules on attitude and knowledge showed similar effects [ 14 , 22 - 26 ] in, for example, end-of-life care, reducing antibiotic prescribing, error reporting, behavior change psychology, and addressing unhealthy alcohol use. Studies investigating the effect of e-learning on communication skills or comprehension of skills are scarce.…”

Section: Discussionmentioning

confidence: 99%

“…Studies investigating the effect of e-learning on communication skills or comprehension of skills are scarce. However, McCarthy et al showed that their program resulted in an improvement of skills in knowing when and how to complete incident forms and disclosing errors [ 14 ]. Daetwyler et al showed that their module improved the skill of breaking “bad news” in a setting with a simulated patient [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

An E-Learning Module to Improve Nongenetic Health Professionals’ Assessment of Colorectal Cancer Genetic Risk: Feasibility Study

et al. 2017

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BackgroundNongenetic health providers may lack the relevant knowledge, experience, and communication skills to adequately detect familial colorectal cancer (CRC), despite a positive attitude toward the assessment of history of cancer in a family. Specific training may enable them to more optimally refer patients to genetic counseling.ObjectiveThe aim of this study was to develop an e-learning module for gastroenterologists and surgeons (in training) aimed at improving attitudes, knowledge, and comprehension of communication skills, and to assess the feasibility of the e-learning module for continued medical education of these specialists.MethodsA focus group helped to inform the development of a training framework. The e-learning module was then developed, followed by a feasibility test among a group of surgeons-in-training (3rd- and 4th-year residents) and then among gastroenterologists, using pre- and posttest questionnaires.ResultsA total of 124 surgeons-in-training and 14 gastroenterologists participated. The e-learning was positively received (7.5 on a scale of 1 to 10). Between pre- and posttest, attitude increased significantly on 6 out of the 10 items. Mean test score showed that knowledge and comprehension of communication skills improved significantly from 49% to 72% correct at pretest to 67% to 87% correct at posttest.ConclusionsThis study shows the feasibility of a problem-based e-learning module to help surgeons-in-training and gastroenterologists in recognizing a hereditary predisposition in patients with CRC. The e-learning led to improvements in attitude toward the assessment of cancer family history, knowledge on criteria for referral to genetic counseling for CRC, and comprehension of communication skills.

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“…Historically junior doctors were perceived as being a ‘high risk’ group bringing little experience, often provided with limited and inadequate supervision and experiencing high stress levels [6]. More recently authors have outlined the potential of involving junior doctors in improving patient care [7, 8] and in preventing, reporting and learning from near misses and adverse events [9]. We contend that junior doctors are in a unique position in relation to reporting of incidents and safety culture.…”

Section: Introductionmentioning

confidence: 99%

The co-design, implementation and evaluation of a serious board game ‘PlayDecide patient safety’ to educate junior doctors about patient safety and the importance of reporting safety concerns

et al. 2019

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Background We believe junior doctors are in a unique position in relation to reporting of incidents and safety culture. They are still in training and are also ‘fresh eyes’ on the system providing valuable insights into what they perceive as safe and unsafe behaviour. The aim of this study was to co-design and implement an embedded learning intervention – a serious board game – to educate junior doctors about patient safety and the importance of reporting safety concerns, while at the same time shaping a culture of responsiveness from senior medical staff. Methods A serious game based on the PlayDecide framework was co-designed and implemented in two large urban acute teaching hospitals. To evaluate the educational value of the game voting on the position statements was recorded at the end of each game by a facilitator who also took notes after the game of key themes that emerged from the discussion. A sample of players were invited on a voluntary basis to take part in semi-structured interviews after playing the game using Flanagan’s Critical Incident Technique. A paper-based questionnaire on ‘Safety Concerns’ was developed and administered to assess pre-and post-playing the game reporting behaviour. Dissemination workshops were held with senior clinicians to promote more inclusive leadership behaviours and responsiveness to junior doctors raising of safety concerns from senior clinicians. Results The game proved to be a valuable patient safety educational tool and proved effective in encouraging deep discussion on patient safety. There was a significant change in the reporting behaviour of junior doctors in one of the hospitals following the intervention. Conclusion In healthcare, limited exposure to patient safety training and narrow understanding of safety compromise patients lives. The existing healthcare system needs to value the role that junior doctors and others could play in shaping a positive safety culture where reporting of all safety concerns is encouraged. Greater efforts need to be made at hospital level to develop a more pro-active safe and just culture that supports and encourages junior doctors and ultimately all doctors to understand and speak up about safety concerns. Electronic supplementary material The online version of this article (10.1186/s12909-019-1655-2) contains supplementary material, which is available to authorized users.

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Online patient safety education programme for junior doctors: is it worthwhile?

Cited by 16 publications

References 25 publications

A Narrative Review of Strategies to Increase Patient Safety Event Reporting by Residents

A Narrative Review of Strategies to Increase Patient Safety Event Reporting by Residents

An E-Learning Module to Improve Nongenetic Health Professionals’ Assessment of Colorectal Cancer Genetic Risk: Feasibility Study

The co-design, implementation and evaluation of a serious board game ‘PlayDecide patient safety’ to educate junior doctors about patient safety and the importance of reporting safety concerns

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