Patient safety in health care professional educational curricula: examining the learning experience

This study has investigated the formal and informal ways pre-registration students from four healthcare professions learn about patient safety in order to become safe practitioners. The study aims to understand some of the issues which impact upon teaching, learning and practising patient safety in academic, organisational and practice „knowledge? contexts. In Stage 1 we used a convenience sample of 13 educational providers across England and Scotland linked with five universities running traditional and innovative courses for doctors, nurses, pharmacists and physiotherapists. We gathered examples of existing curriculum documents for detailed analysis, and interviewed course directors and similar informants. In Stage 2 we undertook 8 case studies to develop an in-depth investigation of learning and practice by students and newly qualified practitioners in universities and practice settings in relation to patient safety. Data were gathered to explore the planning and implementation of patient safety curricula; the safety culture of the places where learning and working take place; the student teacher interface; and the influence of role models and organisational culture on practice. Data from observation, focus groups and interviews were transcribed and coded independently by more than one of the research team. Analysis was iterative and ongoing throughout the study. NHS policy is being taken seriously by course leaders, and Patient Safety material is being incorporated into both formal and informal curricula. Patient safety in the curriculum is largely implicit rather than explicit. All students very much value the practice context for learning about patient safety. However, resource issues, peer pressure and client factors can influence safe practice. Variations exist in students? experience, in approach between university tutors, different placement locations – the experience each offers – and the quality of the supervision available. Relationships with the mentor or clinical educator are vital to student learning. The role model offered and the relationship established affects how confident students feel to challenge unsafe practice in others. Clinicians are conscious of the tension between their responsibilities as clinicians (keeping patients safe), and as educators (allowing students to learn under supervision). There are some apparent gaps in curricular content where relevant evidence already exists – these include the epidemiology of adverse events and error, root cause analysis and quality assessment. Reference to the organisational context is often absent from course content and exposure limited. For example, incident reporting is not being incorporated to any great extent in undergraduate curricula. Newly qualified staff were aware of the need to be seen to practice in an evidence based way, and, for some at least, the need to modify „the standard? way of doing things to do „what?s best for the patient?. A number of recommendations have been made, some generic and others specific to individual professions. Regulators? expectations of courses in relation to patient 9 safety education should be explicit and regularly reviewed. Educators in all disciplines need to be effective role models who are clear about how to help students to learn about patient safety. All courses should be able to highlight a vertical integrated thread of teaching and learning related to patient safety in their curricula. This should be clear to staff and students. Assessment for this element should also be identifiable as assessment remains important in driving learning. All students need to be enabled to constructively challenge unsafe or non-standard practice. Encounters with patients and learning about their experiences and concerns are helpful in consolidating learning. Further innovative approaches should be developed to make patient safety issues 'real' for students

A pilot study of operating department practitioners undertaking high-risk learning: a comparison of experiential, part-task and hi-fidelity simulation teaching methods

Health care learners commonly rely on opportunistic experiential learning in clinical placements in order to develop cognitive and psychomotor clinical skills. In recent years there has been an increasing effort to develop effective alternative, non-opportunistic methods of learning, in an attempt to bypass the questionable tradition of relying on patients to practice on. As part of such efforts, there is an increased utilisation of simulation-based education. However, the effectiveness of simulation in health care education arguably varies between professions (Liaw, Chan, Scherpbier, Rethans, & Pua, 2012; Oberleitner, Broussard, & Bourque, 2011; Ross, 2012). This pilot study compares the effectiveness of three educational (or ‘teaching’) methods in the development of clinical knowledge and skills during Rapid Sequence Induction (RSI) of anaesthesia, a potentially life-threatening clinical situation. Students of Operating Department Practice (ODP) undertook either a) traditional classroom based and experiential learning, b) part-task training, or c) fully submersive scenario-based simulated learning

Effectiveness of a Multimodal Mindfulness Program for Student Health Care Professionals: A Randomized Controlled Trial

Background: The effectiveness of a multimodal mindfulness program incorporating traditional and nontraditional forms of active and nonactive meditation practices with a sample of occupational and physical therapy students was assessed in this study. Method: Thirty-six participants were randomly assigned to an intervention or control group. The 8-week mindfulness program consisted of one weekly 40-min in-person group session and four weekly 10-min online guided meditations. Pre and postintervention measures included the Perceived Stress Scale (PSS), Student Stress Management Scale (SSMS), mindfulness activity log, open-ended qualitative questionnaire, GPA, and counseling visit frequency. Results: Statistically significant differences, with large effect sizes, were found between intervention and control group PSS (Z=-4.291, pd=-1.84) and SSMS (Z=-3.330, pd=-1.27) postintervention scores. Statistically significant differences, with large effect sizes, were found between intervention group pre and postmindfulness activity ratings for each week and all weeks combined (Z=-12.599, pd=1.29). Qualitative data revealed eight themes including greater sleep quality, energy levels, self-compassion, and life-work balance. No statistically significant differences were found between intervention and control group counseling visit frequency and GPA. Conclusion: As this is preliminary data about a novel intervention with a small student sample, effectiveness of this intervention should be further explored in a replication study