Applying the trigger review method after a brief educational intervention: potential for teaching and improving safety in GP specialty training?

<p>Background: The Trigger Review Method (TRM) is a structured approach to screening clinical records for undetected patient safety incidents (PSIs) and identifying learning and improvement opportunities. In Scotland, TRM participation can inform GP appraisal and has been included as a core component of the national primary care patient safety programme that was launched in March 2013. However, the clinical workforce needs up-skilled and the potential of TRM in GP training has yet to be tested. Current TRM training utilizes a workplace face-to-face session by a GP expert, which is not feasible. A less costly, more sustainable educational intervention is necessary to build capability at scale. We aimed to determine the feasibility and impact of TRM and a related training intervention in GP training.</p> Methods We recruited 25 west of Scotland GP trainees to attend a 2-hour TRM workshop. Trainees then applied TRM to 25 clinical records and returned findings within 4-weeks. A follow-up feedback workshop was held. <p>Results: 21/25 trainees (84%) completed the task. 520 records yielded 80 undetected PSIs (15.4%). 36/80 were judged potentially preventable (45%) with 35/80 classified as causing moderate to severe harm (44%). Trainees described a range of potential learning and improvement plans. Training was positively received and appeared to be successful given these findings. TRM was valued as a safety improvement tool by most participants.</p> <p>Conclusion: This small study provides further evidence of TRM utility and how to teach it pragmatically. TRM is of potential value in GP patient safety curriculum delivery and preparing trainees for future safety improvement expectations.</p&gt

A survey of dental school applicants’ career intentions and the balance with family life

Purpose To investigate the career plans of prospective dental students and how they foresee their work life balance.\ud \ud Method Applicants to Dundee and Manchester dental schools completed anonymous questionnaires when they attended for interview.\ud \ud Results The useable response rate was 94% (n=436). The majority of the respondents (91.3%) intended working full time when they enter the workforce, with no significant variation detected between males and females. The cohort anticipated their mean salary to be just over £28,000 five years into their career, although the males felt they would be earning £5,000 more than the females. Individuals of Pakistani and Indian origin thought they would earn most, and Asians least.\ud \ud Sixty-five per cent would enter general dental practice and, of these, only 2.8% expected to work exclusively within the NHS. Fifteen per cent intended to go into the hospital dental service, with orthodontics the most popular choice of subspecialty (43.7%), followed by oral surgery (31.1%). Significant variation was seen between ethnic groups, with the hospital and community dental services being more popular with those who identified themselves as of non-white ethnic origin, although the majority would still plan on entering general dental practice.\ud \ud Almost half (44.5%) would take time out of their career to concentrate on childcare when children were of pre-school age, with a further 11% taking longer. Ninety per cent of females and 70% of males anticipated taking time out, of a varying duration. Half of the respondents indicated that they felt a child would affect their career to a moderate extent.\ud \ud Conclusions The dental profession will be severely affected if both males and females take time out of their careers in the future. As well as a work force shortage, the problems of accessibility to NHS dental services will be exacerbated if fewer dentists choose to provide NHS care