Development of an International Tool for Students to Record and Reflect on Patient Safety Learning Experiences

The second victim phenomenon: A qualitative study among bachelor's degree nursing students within the clinical learning environment

AIM

This study explores and describes the second victim phenomenon in nursing students in association with the characteristics of the clinical learning environment and the clinical supervision process.

DESIGN

Qualitative design using conventional content analysis and summative content analysis approaches.

METHODS

From September 2022 to July 2023, in-depth semi-structured individual interviews were conducted with a purposive sample of 10 undergraduate nursing students.

RESULTS

Six main themes were developed: 'defining the physical and psychological responses after the most significant patient safety incident', 'analyzing the characteristics of patient safety incidents', 'creating a safe learning environment to provide the best care for patients', 'developing mentorship capabilities and qualities for an ideal follow up of students as a second victim', 'providing resources and integrating support structures to second victim nursing students during their clinical learning', and 'considering the cooperation and coordination between the health institution and the higher education institutions.'

CONCLUSION

Nursing students become second victims during their clinical placement. The clinical learning environment and mentoring characteristics influence the second victim experience.

Unveiling the hidden struggle of healthcare students as second victims through a systematic review

BACKGROUND

When healthcare students witness, engage in, or are involved in an adverse event, it often leads to a second victim experience, impacting their mental well-being and influencing their future professional practice. This study aimed to describe the efforts, methods, and outcomes of interventions to help students in healthcare disciplines cope with the emotional experience of being involved in or witnessing a mistake causing harm to a patient during their clerkships or training.

METHODS

This systematic review followed the PRISMA guidelines and includes the synthesis of eighteen studies, published in diverse languages from 2011 to 2023, identified from the databases MEDLINE, EMBASE, SCOPUS and APS PsycInfo. PICO method was used for constructing a research question and formulating eligibility criteria. The selection process was conducted through Rayyan. Titles and abstracts of were independently screened by two authors. The critical appraisal tools of the Joanna Briggs Institute was used to assess the risk of bias of the included studies.

RESULTS

A total of 1354 studies were retrieved, 18 met the eligibility criteria. Most studies were conducted in the USA. Various educational interventions along with learning how to prevent mistakes, and resilience training were described. In some cases, this experience contributed to the student personal growth. Psychological support in the aftermath of adverse events was scattered.

CONCLUSION

Ensuring healthcare students' resilience should be a fundamental part of their training. Interventions to train them to address the second victim phenomenon during their clerkships are scarce, scattered, and do not yield conclusive results on identifying what is most effective and what is not.

Prehospital nursing students' experiences of patient safety culture in emergency medical services-A qualitative study

AIMS AND OBJECTIVES

To describe prehospital nursing students' experiences of patient safety culture in emergency medical services during their internship.

BACKGROUND

Patient safety culture in the emergency medical services is a complex phenomenon including more than organisational policies and practices and professionals' technical skills.

DESIGN

The descriptive qualitative approach used the Sharing Learning from Practice to improve Patient Safety Learning Event Recording Tool, which includes both open-ended and structured questions.

METHODS

Purposeful sampling was used, and data were collected from graduating prehospital nursing students (n = 17) from three Finnish Universities of Applied Sciences. Open-ended questions were reviewed using thematic analysis, and frequencies and percentages were derived from structured questions. COREQ guidelines were used to guide this study.

RESULTS

Four themes were identified during the thematic analysis: environmental and other unexpected factors in emergency medical services, working practices and professionalism in emergency medical services, teamwork in emergency medical services and feelings related to patient safety events in emergency medical services. Patient safety events described by students were seldom reported in the healthcare system or patient files. According to the students, such events were most likely related to communication, checking/verification and/or teamwork.

CONCLUSIONS

This study shows that prehospital nursing students can produce important information about patient safety events and the reasons that contributed to those events. Therefore, emergency medical services organisations and managers should use students' observations to develop a patient safety culture in emergency medical services.

RELEVANCE TO CLINICAL PRACTICE

Understanding how prehospital nursing students have experienced patient safety culture during their internships on ambulances can support educational institutions, together with emergency medical services organisations and managers, to improve policies for students to express patient safety concerns as well as patient safety successes.

A qualitative exploration of undergraduate nursing students' experience of emotional safety for learning during their clinical practice

BACKGROUND

During their clinical practice, nursing students learn to manage patient safety through their experiences, emotions, and interpersonal relationships.

OBJECTIVES

To explore contextual and mechanistic factors that facilitate a sense of emotional safety for learning in nursing students, particularly regarding patient safety events experienced during their placements.

DESIGN

A descriptive qualitative study using narratives and thematic analysis.

SETTINGS

A university in Northern Italy.

PARTICIPANTS

Undergraduate nursing students recruited through purposive sampling.

METHODS

Twenty cases relevant to the present study were selected from the "Sharing LearnIng from Practice for Patient Safety" (SLIPPS) project database containing 100 narratives collected using the patient safety learning Event Recording Tool. The data were analysed using thematic analysis according to Braun & Clarke's methodology. The themes that emerged from the thematic analysis were rearranged in Context-Mechanism-Outcomes.

RESULTS

Students identified clinical practice experiences as important occasions for their personal and professional development. Emotional safety and tutoring were the elements that effectively "govern" the students' learning and development process.

CONCLUSIONS

Emotional safety is key for nursing students because it enables them to constructively overcome any relational and emotional tensions that may develop during their clinical placements.