Critical incidence reporting about medical teaching.

Abstract

Previous end-of-semester evaluation cycles at our medical school revealed critical incidents about medical teaching. In one instance, a lecturer had frightened students, and in another case, a learning video contained misogynist statements. However, incident information reached the office of the dean too late for appropriate measures. Critical teaching incidents can compromise students and lecturers personally and may adversely affect the medical training. Early identification and efficient resolution are required to protect personal integrity and wellbeing of all parties, to ensure teaching quality and to prevent future incidents. Although critical incident reporting systems (CIRS) are well established in healthcare systems to prevent patient harm, a personal approach of complained management is still common in the field of teaching. However, due to the large number of students and the broad range of issues that could arise, an appropriate processing appears not to be warranted. Emotional thresholds and confidentiality requirements may prevent students and lecturers to address complaints and concerns. Parties may fear social pressure, disadvantages in their studies or work, and reprisal. We set up a CIRS which was made available to students and lecturers after only 2 months of development and roll out of the associated IT project. To this end, we used an agile project management methodology based on the Scrum framework because of its simplicity, its potential of adaption and its ability to enhance team productivity.1 Development started with definition of needs regarding the CIRS, the so-called ‘product backlog’ by the ‘product owner’ represented by the Dean for medical education. Only minimum requirements of functionality were claimed for the time of launch. Subsequently, the ‘Scrum master’, in person the head of eHealth applications, called a meeting with the development team to prioritise activities and divide the project into ‘sprint cycles’ that should be completed within a two-month time-box. The development team consisted of the division head of student- and lecturer administration, the division head of quality development in medical education, and the university hospital healthcare risk manager. During the following Scrum process, frequent brief meetings were held to adjust prioritisation of tasks according to upcoming challenges and impediments and to functionalities achieved so far. CIRS for teaching was launched in due time. The CIRS application works on the learning management system of our medical school. Access is available for enrolled students and lecturers of the respective courses. Anonymity of submitters is ensured unless they agree to their identities being revealed. Incidences were categorised within a pre-defined drop-down menu. Categories included unacceptable behaviours of lecturers or students, no-show of the lecturer, poor teaching quality, irregularities during the exam, irregularities about allocation of resources, problems concerning use of digital teaching media, technical and organisational problems to enrol at the university hospital, no availability or cleanliness of course rooms, and miscellaneous. In addition, submitters can enter free text commentaries into a dialogue box. Each input will be sent immediately and directly to the responsible body and may be forwarded to the Dean for medical education depending on importance.