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Zhou L, Sun Y, Wang J, Huang H, Luo J, Zhao Q, Xiao M. Trends in patient safety education research for healthcare professional students over the past two decades: a bibliometric and content analysis. MEDICAL EDUCATION ONLINE 2024; 29:2358610. [PMID: 38861669 PMCID: PMC11168337 DOI: 10.1080/10872981.2024.2358610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 05/17/2024] [Indexed: 06/13/2024]
Abstract
Research and practice in patient safety education have garnered widespread attention; however, a comprehensive bibliometric analysis is lacking. This study aimed to provide a comprehensive understanding of the research focus and research trends in the globalization of the field of patient safety education and to describe the general characteristics of publications. Data on articles and reviews about student safety education were extracted from Web of Science. Microsoft Excel 2019, CiteSpace 6.1.R3, VOSviewer 1.6.18, SATI 3.2, Scimago Graphica, and Pajek were used for quantitative analysis. Collaboration networks of countries, institutions, journals, authors, and keywords were visualized based on publications from January 2000 to September 2022. A total of 573 papers were published between 2000 to 2022, showing an overall increasing trend. The USA, England, and Australia are the top three most prolific countries; Johns Hopkins University, the University of Technology Sydney, and the University of Toronto are the top three most productive institutions; Nurse Education Today, Journal of Nursing Education, and BMC Medical Education are the most productive journals; Based on content analysis five research hotspots focused on: (1) Quality Improvement of Patient safety Teaching and Learning; (2) Patient safety Teaching Content; (3)Specialized Teaching in Patient Safety; (4) Integrating Patient Safety and Clinical Teaching; (5)Patient Safety Teaching Assessment Content. Through keyword clustering analysis, five research hotspots and relevant contents were identified. According to this study, simulation, communication, collaboration, and medication may attract more attention from researchers and educators, and could be the major trend for future study.
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Affiliation(s)
- Lu Zhou
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yinsong Sun
- Orthopaedic Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Wang
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Huanhuan Huang
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Luo
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mingzhao Xiao
- Urology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Plugge T, Breviu A, Lappé K, Sakaeda M, Raaum S. "Near Miss": A Mixed-Methods Analysis of Medical Student Assignments in Patient Safety. Am J Med Qual 2024; 39:168-173. [PMID: 38992902 DOI: 10.1097/jmq.0000000000000196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Abstract
The purpose of this study is to inform the curriculum for Entrustable Professional Activity 13 through analysis of fourth year medical student patient safety event assignments. From 2016 to 2021, students were asked to identify a patient safety event and indicate if the event required an incident report. Assignments were reviewed and coded based on Joint Commission incident definitions. Qualitative analysis was performed to evaluate incident report justification. There were 473 student assignments included in the analysis. Assignments reported incidents regarding communication, medical judgment, medication errors, and coordination of care. Students indicated only 18.0% (85/473) would warrant an incident report. Justification for not filing an incident report included lack of harm to the patient or that it was previously reported. Students were able to identify system issues but infrequently felt an incident report was required. Justifications for not filing an incident report suggest a need for a curriculum focused on the value of reporting near misses and hazardous conditions.
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Affiliation(s)
- Thomas Plugge
- Department of Hospital Medicine, Washington Regional Medical Center, Fayetteville, AR
| | - Amanda Breviu
- Department of Internal Medicine, Intermountain Medical Center, Murray, UT
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Katie Lappé
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Mariah Sakaeda
- Office of Education Quality Improvement, University of Utah School of Medicine, Salt Lake City, UT
| | - Sonja Raaum
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT
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Taylor TA, Kemp K, Mi M, Lerchenfeldt S. Self-directed learning assessment practices in undergraduate health professions education: a systematic review. MEDICAL EDUCATION ONLINE 2023; 28:2189553. [PMID: 36919556 PMCID: PMC10026772 DOI: 10.1080/10872981.2023.2189553] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE The goal of this systematic review was to examine self-directed learning (SDL) assessment practices in undergraduate health professions education. METHODS Seven electronic databases were searched (PubMed, Embase, PsycINFO, ERIC, CINAHL, Scopus, and Web of Science) to retrieve English-language articles published between 2015 and July of 2022, investigating assessment of SDL learning outcomes. Extracted data included the sample size, field of study, study design, SDL activity type, SDL assessment method, number of SDL assessments used, study quality, number of SDL components present utilising the framework the authors developed, and SDL activity outcomes. We also assessed relationships between SDL assessment method and number of SDL components, study quality, field of study, and study outcomes. RESULTS Of the 141 studies included, the majority of study participants were medical (51.8%) or nursing (34.8%) students. The most common SDL assessment method used was internally-developed perception surveys (49.6%). When evaluating outcomes for SDL activities, most studies reported a positive or mixed/neutral outcome (58.2% and 34.8%, respectively). There was a statistically significant relationship between both number and type of assessments used, and study quality, with knowledge assessments (median-IQR 11.5) being associated with higher study quality (p < 0.001). Less than half (48.9%) of the studies used more than one assessment method to evaluate the effectiveness of SDL activities. Having more than one assessment (mean 9.49) was associated with higher quality study (p < 0.001). CONCLUSIONS The results of our systematic review suggest that SDL assessment practices within undergraduate health professions education vary greatly, as different aspects of SDL were leveraged and implemented by diverse groups of learners to meet different learning needs and professional accreditation requirements. Evidence-based best practices for the assessment of SDL across undergraduate healthcare professions education should include the use of multiple assessments, with direct and indirect measures, to more accurately assess student performance.
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Affiliation(s)
- Tracey A.H. Taylor
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Kyeorda Kemp
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Misa Mi
- Medical Library, Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Sarah Lerchenfeldt
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
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Robertson C, Smith K, McGowan A, Sammut T, Boyle JG. New approach to undergraduate quality improvement. CLINICAL TEACHER 2023; 20:e13568. [PMID: 36859750 DOI: 10.1111/tct.13568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 02/10/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND While quality improvement (QI) is an essential component to modern day clinical practice, some foundation doctors fail to engage. This is compounded by a lack of formalised undergraduate QI teaching. We trial an undergraduate active learning workshop and evaluate it using a concurrent triangulation mixed methods design. APPROACH We constructed a 2-hour interactive QI workshop utilising near-peer educators for third year undergraduate medical students. Our workshop demonstrated an exemplary project and a template featuring evidenced-based QI tools to grasp key concepts. Informal support was provided for student QI projects, undertaken in small peer groups. Utility was assessed using linked pre-and-post event questionnaires with Likert scales, free text thematic analysis and project completion rates. EVALUATION We recruited 74 students to attend our workshops delivered over 3 months. We achieved high event satisfaction and significant improvements on baseline confidence. Free text comments suggested students perceive QI as an important part of the undergraduate curriculum, described barriers to engagement and the value they place on project autonomy. The workshop eased student feelings of anxiety and intimidation regarding change ideas. Nine projects were completed with one winning a poster prize at a regional conference. IMPLICATIONS We demonstrate a popular resource light model that can be scaled up to a variety of centres. Targeting QI teaching at the undergraduate level may be instrumental in developing QI culture in health care systems and address barriers to postgraduate involvement. Our study furthers the understanding of undergraduate students' perspectives of QI and demand for further sessions.
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Affiliation(s)
- Callum Robertson
- University Hospital Crosshouse, Kilmarnock, Scotland
- University Hospital Ayr, Ayr, Scotland
- Glasgow Royal Infirmary, Glasgow, Scotland
- School of Medicine, Dentistry and Nursing, Wolfson Medical School Building, University of Glasgow, Glasgow, Scotland
| | - Keenan Smith
- University Hospital Crosshouse, Kilmarnock, Scotland
| | | | | | - James G Boyle
- Glasgow Royal Infirmary, Glasgow, Scotland
- School of Medicine, Dentistry and Nursing, Wolfson Medical School Building, University of Glasgow, Glasgow, Scotland
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Aredo JV, Ding JB, Lai CH, Trimble R, Bromley-Dulfano RA, Popat RA, Shieh L. Implementation and evaluation of an elective quality improvement curriculum for preclinical students: a prospective controlled study. BMC MEDICAL EDUCATION 2023; 23:66. [PMID: 36703204 PMCID: PMC9879619 DOI: 10.1186/s12909-023-04047-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Quality improvement (QI) is a systematic approach to improving healthcare delivery with applications across all fields of medicine. However, exposure to QI is minimal in early medical education. We evaluated the effectiveness of an elective QI curriculum in teaching preclinical health professional students foundational QI concepts. METHODS This prospective controlled cohort study was conducted at a single academic institution. The elective QI curriculum consisted of web-based video didactics and exercises, supplemented with in-person classroom discussions. An optional hospital-based QI project was offered. Assessments included pre- and post-intervention surveys evaluating QI skills and beliefs and attitudes, quizzes, and Quality Improvement Knowledge Application Tool-Revised (QIKAT-R) cases. Within-group pre-post and between-group comparisons were performed using descriptive statistics. RESULTS Overall, 57 preclinical medical or physician assistant students participated under the QI curriculum group (N = 27) or control group (N = 30). Twenty-three (85%) curriculum students completed a QI project. Mean quiz scores were significantly improved in the curriculum group from pre- to post-assessment (Quiz 1: 2.0, P < 0.001; Quiz 2: 1.7, P = 0.002), and the mean differences significantly differed from those in the control group (Quiz 1: P < 0.001; Quiz 2: P = 0.010). QIKAT-R scores also significantly differed among the curriculum group versus controls (P = 0.012). In the curriculum group, students had improvements in their confidence with all 10 QI skills assessed, including 8 that were significantly improved from pre- to post-assessment, and 4 with significant between-group differences compared with controls. Students in both groups agreed that their medical education would be incomplete without a QI component and that they are likely to be involved in QI projects throughout their medical training and practice. CONCLUSIONS The elective QI curriculum was effective in guiding preclinical students to develop their QI knowledge base and skillset. Preclinical students value QI as an integral component of their medical training. Future directions involve evaluating the impact of this curriculum on clinical clerkship performance and across other academic institutions.
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Affiliation(s)
- Jacqueline V Aredo
- Stanford University School of Medicine, Stanford, CA, USA.
- Department of Medicine, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA, 94143, USA.
| | - Jack B Ding
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Cara H Lai
- Stanford University School of Medicine, Stanford, CA, USA
| | | | | | - Rita A Popat
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Lisa Shieh
- Division of Hospital Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Carter J, Capon S, Dyer C, Whittaker M. Quality improvement in the undergraduate medical curriculum: the need for clinical exposure. BMC MEDICAL EDUCATION 2021; 21:467. [PMID: 34470626 PMCID: PMC8411518 DOI: 10.1186/s12909-021-02566-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 02/16/2021] [Indexed: 06/13/2023]
Abstract
This correspondence article aims to outline the importance of an integrated clinical component within Quality Improvement education in response to the recently published article by Shah et al.. The Quality Improvement and Patient Safety workshops described in the above study were compared with the Quality Improvement module experienced by medical students at King's College London. The key difference between the two methods of teaching Quality Improvement was the clinical project undertaken by King's College Students, which helped students gain an appreciation of the pitfalls of instigating change in a clinical environment. The authors feel that this arguably more authentic experience could have benefited the students in the study in making them feel better equipped to use the skills learned in the theoretical workshops in their later careers.
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Affiliation(s)
- Jemima Carter
- Kings College London, GKT School of Medical Education, London, UK.
| | - Suzanne Capon
- Kings College London, GKT School of Medical Education, London, UK
| | - Claire Dyer
- Kings College London, GKT School of Medical Education, London, UK
| | - Maya Whittaker
- Kings College London, GKT School of Medical Education, London, UK
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López-Hernández LB, Díaz BG, Zamora González EO, Montes-Hernández KI, Tlali Díaz SS, Toledo-Lozano CG, Bustamante-Montes LP, Vázquez Cárdenas NA. Quality and Safety in Healthcare for Medical Students: Challenges and the Road Ahead. Healthcare (Basel) 2020; 8:healthcare8040540. [PMID: 33291837 PMCID: PMC7768411 DOI: 10.3390/healthcare8040540] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/23/2020] [Accepted: 11/29/2020] [Indexed: 01/25/2023] Open
Abstract
Background: The development of skills, behaviors and attitudes regarding patient safety is of utmost importance for promoting safety culture for the next generation of health professionals. This study describes our experience of implementing a course on patient safety and quality improvement for fourth year medical students in Mexico during the COVID-19 outbreak. The course comprised essential knowledge based on the patient safety curriculum provided by the WHO. We also explored perceptions and attitudes of students regarding patient safety. Methods: Fourth year medical students completed a questionnaire regarding knowledge, skills, and attitudes on patient safety and quality improvement in medical care. The questionnaire was voluntarily answered online prior to and after the course. Results: In total, 213 students completed the questionnaires. Most students were able to understand medical error, recognize failure and the nature of causation, perform root-cause analysis, and appreciate the role of patient safety interventions. Conversely, a disapproving perspective prevailed among students concerning the preventability of medical errors, utility of reporting systems, just culture and infrastructure (p < 0.05). Conclusion: We found students had a positive perspective concerning learning quality in healthcare and patient safety during our course; nevertheless, their perception of the usefulness of reporting systems to prevent future adverse events and prevent medical errors is uncomplimentary. Medical education should promote error reporting and just culture to change the current perception of medical students.
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Affiliation(s)
- Luz Berenice López-Hernández
- Departamento de Calidad y Seguridad en la Atención Médica, Ciclo de vida, Universidad Autónoma de Guadalajara, Jalisco 45134, Mexico; (K.I.M.-H.); (S.S.T.D.); (L.P.B.-M.); (N.A.V.C.)
- Correspondence:
| | | | | | - Karen Itzel Montes-Hernández
- Departamento de Calidad y Seguridad en la Atención Médica, Ciclo de vida, Universidad Autónoma de Guadalajara, Jalisco 45134, Mexico; (K.I.M.-H.); (S.S.T.D.); (L.P.B.-M.); (N.A.V.C.)
| | - Stephanie Simone Tlali Díaz
- Departamento de Calidad y Seguridad en la Atención Médica, Ciclo de vida, Universidad Autónoma de Guadalajara, Jalisco 45134, Mexico; (K.I.M.-H.); (S.S.T.D.); (L.P.B.-M.); (N.A.V.C.)
| | | | - Lilia Patricia Bustamante-Montes
- Departamento de Calidad y Seguridad en la Atención Médica, Ciclo de vida, Universidad Autónoma de Guadalajara, Jalisco 45134, Mexico; (K.I.M.-H.); (S.S.T.D.); (L.P.B.-M.); (N.A.V.C.)
| | - Norma Alejandra Vázquez Cárdenas
- Departamento de Calidad y Seguridad en la Atención Médica, Ciclo de vida, Universidad Autónoma de Guadalajara, Jalisco 45134, Mexico; (K.I.M.-H.); (S.S.T.D.); (L.P.B.-M.); (N.A.V.C.)
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Li X, Xie F, Li X, Li G, Chen X, Lv J, Peng C. Development, application, and evaluation of a problem-based learning method in clinical laboratory education. Clin Chim Acta 2020; 510:681-684. [DOI: 10.1016/j.cca.2020.08.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/21/2020] [Accepted: 08/24/2020] [Indexed: 10/23/2022]
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