Board #206 - Program Innovation Simulations into Pre-clinical Education for Patient Safety and Teamwork Training (Submission #9754)

Abstract

Objectives Teamwork training and patient safety efforts often focus on culture change.1 Introduction to these topics early in training may contribute to changing an institution’s culture. Of the few examples of undergraduate medical education patient safety courses appear in the literature, curricula involving pre-clinical students were rare2-3 and utilized primarily large lecture and small-group discussion formats.3 In contrast to patient safety for practicing providers, a major challenge in the pre-clinical years is to create the relevance needed to go beyond knowledge and attitudinal changes and achieve higher levels of Kirkpatrick’s framework such as behavioral changes. To achieve this, we describe a comprehensive year-long patient safety course that incorporates adult-learning principles, including “flipped classroom” and team-based learning, as well as technology-enhanced simulations.4 Description The Tulane Interprofessional Patient Safety course (TIPS) uses a combination of teaching methods to cultivate the appropriate degree of relevance to instruct pre-clinical students in patient safety. Students (n=200) work in peer teams composed of 3 medical and 3 nursing students. Pre-session work involves online modules from the Institute for Healthcare Improvement and “flipped classroom” background materials developed specially for the course. As described in the attached table, the curriculum uses a combination of small-group discussion, team-based learning, task-oriented simulations, and mannequin simulations to deliver the patient safety content. Measurements include knowledge, attitudinal, and perception assessments (Team Performance Scale, Value of Teams, and the Readiness for Interprofessional Learning Scale) as well as 360-degree peer evaluations, direct observation checklists using the Team Performance Observation Tool, and narrative descriptions of behaviors in conjunction with facilitated debriefing. Portions of the course (degree of team training) involved randomization. Students showed a significant increase in the attitudinal scores, perception of the value of teams as well as observed team performance during simulations. Conclusion Assess the degree to which the design objectives were achieved, accurate appraisal of limitations, discussion of next steps and future applications. Indicate how outcomes are relevant to potential benefits for healthcare simulation. Describe the contribution of the project to current knowledge, methods or technologies. This curriculum was intended to move patient safety in the pre-clinical years out of theoretical discussions and into hands-on activities more directly related to healthcare delivery. We were able to demonstrate some improvement in perceptions of teamwork and increased awareness of patient safety and clear observations of good teamwork and patient safety behaviors. However, it is not to what extent these improvements are the result of our interventions as control groups were unavailable in the majority of encounters. The extent to which students utilized teamwork training or patient safety material that were not provided by the curriculum (i.e. contamination) is another key limitation. By using various teaching methodologies and designing a curriculum that focuses on simulation scenarios, it is possible for pre-clinical students to demonstrate patient safety behaviors, in addition to increases in knowledge and attitudes.