Background:
National organizations have called for medical school and residency training in patient safety. Although several groups have developed patient safety curricula, techniques for adapting these curricula for medical house officers are not well worked out.
Purpose:
We adapted a patient safety curriculum developed by our malpractice insurance carrier and designed teaching modules for academic hospitalists to use with housestaff at three university hospitals. Goals included delivery of didactic information, increased exchange of ideas between faculty and residents, and improvement in attitudes toward reporting.
Description:
The project was developed by a team of patient safety experts and hospitalist physicians from three hospitals. A team from each hospital developed and pilot tested one module: medication safety, high performance teamwork, and error disclosure. We created teaching notes using a common template with background, sample cases, references, and graphical teaching aids. We included a set of triggers with examples of “teachable moments” that could be used on rounds or at the bedside. Each module also included a slide set designed for a case‐based, interactive resident conference. To disseminate the modules, each team presented their module to residents and faculty members at the other sites. We designed variation into the pedagogical approach: one site integrated safety into weekly rounds on the hospitalist service; another used a large teaching conference. We also created faculty development groups of hospitalists and other clinician‐teachers. These clinicians tested the modules in their practice settings and exchanged potential teaching strategies. To evaluate the curriculum, we surveyed resident physicians before and after each module about their content‐specific knowledge and patient safety attitudes.
Summary of Results:
To date, 55 residents and 16 faculty or chief residents participated in sessions on teamwork and medication safety. The disclosure module is currently being completed. Residents and faculty were eager to share their experiences, regardless of teaching venue. We received anecdotal reports of residents who changed their practice following the modules. In written surveys, we found a non‐significant increase on knowledge scores. After completing 1 or 2 modules, residents were more likely to report a near miss of their own doing (medication module: 68% vs 13%, p <0.01; teamwork module: 38 vs 11%, p=0.016). We identified barriers to teaching patient safety, including heavy service demands on hospitalist faculty and lack of subject matter expertise.
We present an approach to the implementation of a patient safety curriculum for medical and pediatric house officers, and demonstrate attitude changes with even a single intervention. We need to develop a cadre of clinician educators who are comfortable teaching house officers about this subject.
Author Disclosure Block:
A. Tess, None; C. Roy, None; A. Carbo, None; S. Maviglia, None; S. Muret‐Wagstaff, None; J. Hoffman, None; A. Karson, None; C. Coley, None; M. Saadeh, None; S. Weingart, None