Abstract:
BACKGROUND:Distraction and interruption are endemic in the clinical environment and contribute to error. This study assesses whether simulation-based training with targeted feedback can improve undergraduate management of distractions and interruptions to reduce error-making. DESIGN:A prospective non-randomised controlled study. METHODS:28 final year medical students undertook a simulated baseline ward round. 14 students formed an intervention group and received immediate feedback on distractor management and error. 14 students in a control group received no feedback. After 4 weeks, students participated in a post-intervention ward round of comparable rigour. Changes in medical error and distractor management between simulations were assessed with Mann-Whitney U tests using SPSS V.21. RESULTS:At baseline, error rates were high. The intervention group committed 72 total baseline errors (mean of 5.1 errors/student; median 5; range 3-7). The control group exhibited a comparable number of errors-with a total of 76 observed (mean of 5.4 errors/student; median 6; range 4-7). Many of these errors were life-threatening. At baseline distractions and interruptions were poorly managed by both groups. All forms of simulation training reduced error-making. In the intervention group the total number of errors post-intervention fell from 72 to 17 (mean 1.2 errors/student; median 1; range 0-3), representing a 76.4% fall (p<0.0001). In the control group the total number of errors also fell-from 76 to 44 (mean of 3.1 errors/student; median 3; range 1-5), representing a 42.1% reduction (p=0.0003). CONCLUSIONS:Medical students are not inherently equipped to manage common ward-based distractions to mitigate error. These skills can be taught-with simulation and feedback conferring the greatest benefit. Curricular integration of simulated ward round experiences is recommended.
journal_name
BMJ Qual Safjournal_title
BMJ quality & safetyauthors
Thomas I,Nicol L,Regan L,Cleland J,Maliepaard D,Clark L,Walker K,Duncan Jdoi
10.1136/bmjqs-2014-003272subject
Has Abstractpub_date
2015-02-01 00:00:00pages
154-61issue
2eissn
2044-5415issn
2044-5423pii
bmjqs-2014-003272journal_volume
24pub_type
杂志文章abstract:OBJECTIVE:Computerised order sets have the potential to reduce clinical variation and improve patient safety but the effect is variable. We sought to evaluate the impact of changes to the design of an order set on the delivery of chlorhexidine mouthwash and hydroxyethyl starch (HES) to patients in the intensive care un...
journal_title:BMJ quality & safety
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journal_title:BMJ quality & safety
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abstract:BACKGROUND:Experts in patient safety stress the importance of a shared culture of safety. Lack of consensus may be detrimental to patient safety. This study examines differences in patient safety culture perceptions among providers, management and staff in a large national survey of safety culture in ambulatory practic...
journal_title:BMJ quality & safety
pub_type: 杂志文章
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journal_title:BMJ quality & safety
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journal_title:BMJ quality & safety
pub_type: 杂志文章
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journal_title:BMJ quality & safety
pub_type: 杂志文章
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journal_title:BMJ quality & safety
pub_type: 杂志文章
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journal_title:BMJ quality & safety
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pub_type: 杂志文章,评审
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journal_title:BMJ quality & safety
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journal_title:BMJ quality & safety
pub_type: 杂志文章
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journal_title:BMJ quality & safety
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journal_title:BMJ quality & safety
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更新日期:2011-04-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章,评审
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journal_title:BMJ quality & safety
pub_type: 杂志文章
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更新日期:2019-03-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmjqs-2012-001774
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:To empirically assess the quality of hospital care in China and trends over a 5-year period during which the government significantly increased its investment in healthcare. DESIGN:Retrospective, observational study comparing hospital quality between two periods: October 2012-March 2013 and October 2017-Marc...
journal_title:BMJ quality & safety
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journal_title:BMJ quality & safety
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journal_title:BMJ quality & safety
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更新日期:2014-11-01 00:00:00
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journal_title:BMJ quality & safety
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更新日期:2019-09-01 00:00:00
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journal_title:BMJ quality & safety
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更新日期:2018-10-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章,随机对照试验
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更新日期:2018-11-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章
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更新日期:2014-06-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章
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更新日期:2018-08-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章
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更新日期:2015-12-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章
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更新日期:2012-10-01 00:00:00