Effects of a case-based interactive e-learning course on knowledge and attitudes about patient safety: a quasi-experimental study with third-year medical students.

Rainer Gaupp,Mirjam Körner,Götz Fabry

doi:10.1186/s12909-016-0691-4

Rainer Gaupp, Mirjam Körner + Show 1 more

Open Access

https://doi.org/10.1186/s12909-016-0691-4

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Journal: BMC medical education	Publication Date: Jul 11, 2016
Citations: 74	License type: cc-by

Affiliation: University Medical Center Freiburg

Abstract

BackgroundPatient safety (PS) is influenced by a set of factors on various levels of the healthcare system. Therefore, a systems-level approach and systems thinking is required to understand and improve PS. The use of e-learning may help to develop a systems thinking approach in medical students, as case studies featuring audiovisual media can be used to visualize systemic relationships in organizations. The goal of this quasi-experimental study was to determine if an e-learning can be utilized to improve systems thinking, knowledge, and attitudes towards PS.MethodsA quasi-experimental, longitudinal within- subjects design was employed. Participants were 321 third-year medical students who received online surveys before and after they participated in an e-learning course on PS. Primary outcome measures where levels of systems thinking and attitudes towards PS. Secondary outcome measures were the improvement of PS specific knowledge through the e-learning course.ResultsLevels of systems thinking showed significant improvement (58.72 vs. 61.27; p < .001) after the e-learning. Student’s attitudes towards patient safety improved in several dimensions: After the course, students rated the influence of fatigue on safety higher (6.23 vs. 6.42, p < .01), considered patient empowerment more important (5.16 vs. 5.93, p < .001) and realized more often that human error is inevitable (5.75 vs. 5.97, p < .05). Knowledge on PS improved from 36.27 % correct answers before to 76.45 % after the e-learning (p < .001).ConclusionsOur results suggest that e-learning can be used to teach PS. Attitudes towards PS improved on several dimensions. Furthermore, we were able to demonstrate that a specifically designed e-learning program can foster the development of conceptual frameworks such as systems thinking, which facilitates the understanding of complex socio-technical systems within healthcare organisations.

Highlights

Patient safety (PS) is influenced by a set of factors on various levels of the healthcare system
Similar changes occurred in students’ attitudes towards patient safety: The largest difference related to the benefits of patient involvement: After the intervention, students were more positive about the value of patient involvement (5.16 [SD 1.16] vs. 5.93 [SD .95] vs., p < 0.001, Cohen’s d = .73)
Our results suggest that e-learning technology and methodology can be used for knowledge acquisition on theoretical aspects of patient safety

Summary

Introduction

Patient safety (PS) is influenced by a set of factors on various levels of the healthcare system. Improving patient safety requires systems-level interventions within a healthcare organization [2, 12,13,14,15], and it is widely accepted that knowledge alone will not lead to sustainable improvements in patient safety; instead, a holistic approach that includes behavioural and affective interventions is necessary for such improvements [16]. In this regard, educational approaches to patient safety often include conceptual frameworks such as the systems approach [17]. In so doing, such modules prepare the learner for future learning processes in face-to-face action-oriented teaching sessions or clinical settings [25]

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