Patient Safety Education Research Articles

Patient Safety Education for Clinical Students: A Systematic Literature Review

BACKGROUND: Patient safety education has been studied from diverse views, from academic to the professional level, yet research on its effective learning methods remain limited. AIM: This study investigated the implementation of patient safety in the hospital, the significance of patient safety education for students, and the search for effective practical learning methods. METHODS: It employs a systematic review of articles from 2011 to 2021. RESULTS: The research result indicates that patient safety implementation in the hospitals and patient safety education are currently significant trends in search of effective learning methods. Several studies denote that E-Learning and videos on patient safety can effectively increase the students’ knowledge, skill, and attitude. CONCLUSION: With the limitations of scientific writing related to patient safety learning in clinical learners, it is expected that this study can contribute to the development of patient safety teaching in the future. Future research may further examine and analyze the effect of instructional videos in detail.

Are the World Health Organization's Patient Safety Learning Objectives Still Up-to-Date: A Group Concept Mapping Study.

The World Health Organization (WHO) Patient Safety Curriculum Guide defines learning objectives for patient safety. Current implementation in healthcare education is insufficient. Possible explanations may be obsolescence and/or a shift in needs. We investigated whether overarching topics and specific learning objectives of the WHO Patient Safety Curriculum Guide are still up-to-date, their attributed importance, and their perceived difficulty to achieve. Experts on patient safety and medical education from 3 European countries were asked to suggest learning objectives concerning patient safety using group concept mapping. Following 3 successive steps, experts rated ideas by importance and difficulty to achieve. Correlation analyses investigated the relationship between those. Overarching topics of the learning goals (clusters) were identified with multivariate analysis. A total of 119 statements about intended learning objectives on patient safety were generated, of which 86 remained for sorting and rating. Based on multivariate analyses, 10 overarching topics (clusters) emerged. Both the learning objectives and the overarching topics showed high correspondence with the WHO Patient Safety Curriculum Guide. Strong correlations emerged between importance and difficulty ratings for learning objectives and overarching topics. The WHO Patient Safety Curriculum Guide's learning goals are still relevant and up-to-date. Remarkably, learning objectives categorized as highly important are also perceived as difficult to achieve. In summary, the insufficient implementation in medical curricula cannot be attributed to the content of the learning goals. The future focus should be on how the WHO learning goals can be implemented in existing curricular courses.

Evaluating medical students’ ability to identify and report errors: finding gaps in patient safety education

ABSTRACT Background Although there are frequent complaints of medical students’ incompetence in reporting errors, few studies have examined their error-reporting abilities in the real world. Objectives Three sub-functions of self-regulation theory were used to evaluate medical students’ ability to identify errors (self-monitoring), analyse root causes (self-judgment), and devise improvement plans (self-reactions). In addition, whether students reacted differently to their errors and those of others (three sub-functions) was also examined. Methods A total of 952 patient safety reports were reviewed retrospectively, submitted by third-year medical students between 2016 and 2018. Data were quantitatively and qualitatively analysed to investigate who committed the error, to identify the type of error and its root causes, and to find suggested improvement plans. Chi-square and Fisher’s exact tests were used to compare students’ responses to error origins. Results Students reported other errors more frequently than their own (67.6% vs. 32.4%). They reported common critical medical errors, including errors related to engaging with patients (34.5%), invasive procedures (20.2%), and infection (18.5%). The root causes identified were more precise than the improvement plans by the students (75.5% vs. 18.4%, respectively). The students’ improvement plans were not practical, especially at the patient level (25.8%). When students committed errors, they considered human factors such as fatigue, scheduling, and training as the most common root cause, focussing on improvement plans at the individual level. Conclusions The results suggest that students were good at self-judgment, but not at self-monitoring and self-reactions. They reacted differently, based on who committed the error. To enhance self-regulated learning, Educators should encourage students to confront their errors, reflect on their self-reactions towards errors, develop well-being with time management, and think about the meaning of patient-centredness. Finally, active participation in clinical clerkship longitudinally may provide students with opportunities to learn from their errors.

Patient safety awareness, knowledge and attitude about fire risk assessment during time-out among perioperative nurses inKorea.

AimThis study aims to investigate the relationship between patient safety awareness, knowledge (risk‐Knowledge) and attitude about fire risk assessment during time‐out (risk‐Attitude) of perioperative nurses.DesignA cross‐sectional study.MethodsPerioperative nurses (N = 158) from 22 small‐ and medium‐sized hospitals participated in the study. Participants’ characteristics, knowledge and attitude about fire risk assessment were investigated using structured questionnaires.ResultsPatient safety awareness, risk‐Knowledge and risk‐Attitude scores were high among nurses who received frequent patient safety education or fire preparedness training, while patient safety awareness partially mediated the effect of risk‐Knowledge on risk‐Attitude. To increase perioperative nurses’ risk‐Attitude, it would be effective to increase not only their risk‐Knowledge but also overall patient safety awareness.

Governance for Patient Safety: A Framework of Strategy Domains for Risk Management.

Adverse events in healthcare are primarily due to system failures rather than individuals. Risk reduction strategies should therefore focus on strengthening systems, bringing about improvements in governance, and targeting individual practices or products. The purpose of this study was to conduct a scoping review to develop a global framework of management strategies for sustaining a safety-oriented culture in healthcare organizations, focusing on patient safety and the adoption of good safety-related practices. We conducted a search on safety-related strategies in 2 steps. The first involved a search in the PubMed database to identify effective, broadly framed, cross-sector domains relevant to clinical risk management strategies in healthcare systems. In the second step, we then examined the strategies adopted by running a scoping review for each domain. Our search identified 8 strategy domains relevant to patient safety: transformational leadership, patient engagement, human resources management quality, innovation technology, skills certification, education in patient safety, teamwork, and effective communication. This scoping review explores management strategies key to healthcare systems' efforts to create safety-oriented organizations. Improvement efforts should focus particularly on the domains identified: combined together, they would nurture an overall safety-oriented culture and have an impact on preventable adverse events.

Integrating patient safety in the existing undergraduate medical curriculum

The field of medicine has made significant advancements owing to multiple scientific innovations, and the outcome is quite evident in terms of improvement in the health outcomes. The aim of the current review is to understand the magnitude of the problem, scope of patient safety in undergraduate medical education, and components of the same. An extensive search of all materials related to the topic was carried out in the PubMed search engine and World Health Organization website. Overall, 20 articles were selected based upon the suitability with the current review objectives and analyzed. Keywords used in the search include patient safety and medical education in the title alone only. If we really aim to minimize the errors on our part and thereby improve the patient safety, the ideal approach will be to train the undergraduate medical students about different aspects of patient safety during their training period. We must understand that mere knowledge about patient safety (Knows level in Miller's Pyramid) will not serve the desired purpose. Rather, the better approach will be to target knows how and even does level in Miller's Pyramid, as ensuring patient safety is predominantly a skill. To conclude, patient safety curriculum is an important component of the medical undergraduate training. The need of the hour is to acknowledge the importance of patient safety, plan for its integration within the existing curriculum, and implement the same with the help of faculty members.

A Quality Education: A Comprehensive Review of a Combined Longitudinal and Specialty Track Quality Improvement and Patient Safety Medical School Curriculum.

Structured quality improvement and patient safety (QI/PS) education has increased at every level of medical education; however, great variability exists in the content taught. Here, the authors present a longitudinal model for medical student QI/PS education that is currently implemented at the University of Florida College of Medicine. The curriculum is taught with a variety of teaching methods incorporated into each year with increasing levels of clinical implementation. This curriculum is multimodal and introduces students to QI/PS concepts, presents mock scenarios, and eventually encourages clinical application to situations students experience during their own clinical practice. Additionally, a specialized track for students to have further immersion into this field of medicine is described, which involves specialized training, expanded educational opportunities, and a capstone project. Both the curriculum and specialized track contain explicit clinical integration to ensure students are prepared to enter the medical profession to engage in QI/PS endeavors.

6. Extrinsic Factors for Learning: from a Perspective of Patient Safety Education

6. Extrinsic Factors for Learning: from a Perspective of Patient Safety Education

Patient safety in nursing technician training.

to analyze the contents on patient safety in the training of nursing technicians. a documentary study, conducted in three technical nursing courses at a public university in northeastern Brazil, based on the Multi-Professional Patient Safety Curriculum Guide, published by the World Health Organization. we found that, of the 26 subjects in each course, the tracking terms were found in 22 subjects in the A/C courses, 23 in the B course. The topics of the guide with the highest number of terms were the improvement in medication safety, with 85 terms (22.6%), and Infection prevention and control, with 75 terms (20%). The contents do not express the comprehensiveness of patient safety education; some subjects had this focus, while others did not. the documents revealed gaps in the contents related to patient safety and demonstrated that they are addressed only in the course syllabus and discipline plans.

Practice of Human Factors Training Based on SHEL Model:Patient Safety Education for First Year Medical Students

Practice of Human Factors Training Based on SHEL Model:Patient Safety Education for First Year Medical Students

Delivering interprofessional patient safety education using storytelling, a real-life medication error, and synchronous online platform

Introduction Interprofessional education (IPE) about patient safety positively impacts safety and reduces errors but is challenging to deliver. We aimed to determine if a synchronous virtual IPE program using storytelling and interactive learning impacted student perceptions about patient safety. Methods An IPE patient safety program involving medical and pharmacy students was synchronously delivered virtually due to the COVID-19 pandemic. The program was framed using storytelling about a medication error told by a family member. Post-program survey data, exploring participants’ perspectives on the program, collected between July 2020 and November 2020 was retrospectively reviewed. Quantitative results were grouped by the five components of the program. Responses within each category were averaged to generate a summary measure of each student’s experience. Qualitative feedback from two survey questions was evaluated. Results There were 236 (96.7% of participants) completed surveys included in the analysis. High proportions of participants responded favorably across all five components of the survey. Qualitative responses were largely positive, with themes of increased empathy, behavior, and attitude change, and meaning making. Conclusion An interactive IPE patient safety program using storytelling about a real-life medication error to frame activities and utilizing a virtual platform was a favorable and impactful method to educate students.

Learning From Student Experience: Development of an International Multimodal Patient Safety Education Package.

Patient safety is a global concern. Learning to provide safe, high-quality care is core to nursing education. Students are exposed to diverse clinical practices, and experiences may vary between placements and across countries. Student experience is seldom used as an educational resource. An international, European Union-funded project, Sharing Learning from Practice for Patient Safety (SLIPPs), aimed to develop an innovative online educational package to assist patient safety learning. Based on student reported data and educational theory, multiple elements were iteratively developed by a multicountry, multidisciplinary group. The educational package is freely available on the SLIPPs Web site. Materials include a student reporting and reflection tool, virtual seminars, student reports data set, pedagogical game, high-fidelity simulation scenarios, scenario development and use guidelines, debriefing session model, and videos of simulations already performed. E-learning enables removal of physical barriers, allowing educators, professionals, and students from all over the world to collaborate, interact, and learn from each other.

Nurses’ Willingness to Report Near-Miss And Their Perception of Patients’ Safety Culture

Background: Reporting of near-miss safety events is commonly assumed to enhance safety in organizations, as such reporting enables managers to identify and address accident risk factors. Aim: This study aimed to explore nurses’ willingness to report near-miss and their perception of patients’ safety culture. Methodology: A cross-sectional descriptive research design was used to conduct this research. A convenient sample of 300 nurses over a period of four months, were recruited from Beni suef university hospital and Beni-Suef Chest Hospital. Three tools were used as follow; a sociodemographic form; nurses’ willingness to report near-misses scale and nurses’ perception of patient safety culture. Results: There was a significant positive linear correlation between nurses’ willingness to report near-misses and their perception of patient safety culture at r. 0.568, and p. value <0.01. Also, the ANOVA analysis explained that critical department, experience, and attended training courses had a high-frequency positive effect on nurses’ willingness to report near-misses. Conclusion: Nurses generally showed a moderate willingness to report near-misses and a moderate perception of patient safety culture. Recommendation: Integrate near-miss reporting and patient safety education into staff training to increase nurses’ awareness of the value of near-misses reporting which will significantly improve patient safety.

Editorial introductions.

Editorial introductions.

Nursing Students' Informal Learning of Patient Safety Management Activities.

Nursing students require experience in patient safety management to prevent accidents that compromise patient safety. This study examined the mediating effects of informal learning on nursing students’ patient safety management activities. Responses to questionnaires issued to 136 nursing students in South Korea were analyzed. The independent, mediating, and dependent variables used were nursing competencies, informal learning, and patient safety management activities, respectively. Concept validity and model fitness were confirmed using average variance extracted and composite reliability. Model fitness was confirmed using the goodness-of-fit index, normed fit index, Tucker–Lewis index, comparative fit index, and standardized root mean squared residual. The mediating effect was analyzed using the maximum likelihood method, and statistical significance was assessed through bootstrapping. Informal learning mediated the relationship between nursing competence and patient safety management activities. To improve the implementation of patient safety management activities and increase patient safety competence, learning and teaching of specific patient safety-related knowledge, skills, and attitudes need to be improved. For this, informal learning opportunities (e.g., simulation education and clinical practice) must be increased in the nursing curriculum, and the patient safety education capacity should be increased to maintain continuity and connectivity in clinical practice.

간호 · 간병통합서비스 병동 간호사의 비판적 사고성향과 의사소통 명확성이 환자안전역량에 미치는 영향

Objective: The purpose of this study is to analyze the effects of critical thinking disposition and communication clarity of nurses in integrated nursing care units on the patient safety competence to strengthen the patient safety competence of nurses in integrated nursing care units.<BR>Background: Since 2016, it has been implemented as an integrated nursing care service in which professional nursing personnel provide holistic specialized nursing including nursing. However, the integrated nursing care service does not adequately reflect realistic nursing needs, so safety accidents such as falls or bedsores may inevitably occur. Therefore, the patient safety competence of nurses in integrated nursing care units is very important, and critical thinking disposition and communication clarity for patient safety are very important.<BR>Method: Data collection was conducted using a structured questionnaire for a total of 14 days from February 24 to March 10, 2021, targeting 230 nurses in integrated nursing care units of four general hospitals with 300 beds or more in B City. The collected data were analyzed by the SPSS 25.0 program.<BR>Results: Factors affecting patient safety competence of subjects were communication clarity (β=.54, p＜.001), critical thinking disposition (β=.18, p=.015), and completion of patient safety education within the last 1 year (β=.13, p=.012), these variables explained 45% of the patient safety competence of nurses in integrated nursing care units.<BR>Conclusion: It was confirmed that the critical thinking disposition, communication clarity, and completion of patient safety education of nurses in the nursing care integrated service ward were influencing factors on patient safety competence. Therefore, it is necessary to strengthen patient safety education to meet the educational needs of nurses. In other words, it is thought that it is necessary to develop and apply a video education program that is less than two hours in length with enhanced infection control education, including acute respiratory infectious disease management, and a specific and practical education program to improve critical thinking disposition and communication clarity.<BR>Application: The results might help to utilize them as basic data for nursing intervention plan to improve patient safety competence.

Combining simulation and cinemeducation to teach patient safety: A pilot study

ABSTRACT Cinemeducation has been used for diverse teaching objectives in medical education. To our knowledge, there are no published accounts of using cinemeducation in combination with simulation. We designed a pedagogical activity combining cinemeducation and simulation in a programme to teach patient safety. This paper aims to describe the design and implementation of the activity, analyse its feasibility, and assess students’ opinions of its usefulness. A total of 70 second-year Spanish medical students participated; 31 (44.3%) completed a survey assessing the activity. Most expressed total or partial agreement with statements indicating activity was useful. The combined activity facilitates the reflective process by applying the emic/etic perspective. While simulations and cinemeducation share experiential learning techniques, adding cinemeducation helps overcome some of simulation’s limitations in reproducing complex professional scenarios. This combined approach is feasible and well accepted. Combining these two approaches promises to be useful in other disciplines.

Patient safety attitudes in the next generation of healthcare providers. A review of the literature

Abstract Background A comprehensive understanding of the attitudes towards patient safety of the new generation of healthcare workers is fundamental not only for ensuring safe, high-quality care in the present but also for creating a safer healthcare setting in the future. This study aimed to systematically review the literature on patient safety attitudes of health professional students, new graduates, newly registered health professionals, and resident trainees, and to examine potential differences in this population with respect to year of study, specialty, and gender. Methods We searched four databases (i.e., PubMed, Web of Science, Scopus, and PsycInfo) up to 20/02/2020 and screened also additional sources, including weekly, automatic e-mailed search alerts up to 18/10/2020. Two reviewers independently performed all methodological steps (i.e., search, study selection, quality appraisal, data extraction and formal narrative synthesis), including a third reviewer in case of disagreement. Results We identified 6606 records, assessed 188 full-texts, and included 31 articles. Across studies, healthcare students and young professionals reported more positive patient safety attitudes in certain domains (e.g., teamwork climate, error inevitability, received patient safety training) but showed more negative attitudes in other areas (e.g., management support, safety climate, disclosure responsibility). Women and persons with more years of study and training demonstrated more positive attitudes towards patient safety. Conclusions Healthcare students should receive early curricular education in patient safety to build a solid foundation for the development of a strong and healthy safety culture. Understanding the differences in attitudes between aspiring healthcare providers from different areas is important to tailor teaching and training to the specific needs of certain populations. Key messages According to the reviewed literature, young healthcare students and professionals’ attitudes towards patient safety differed across domains. Institutions should increase education and training on patient safety for aspiring healthcare professionals, tailor them to the specific needs of this population, and monitor attitudes over time.

Theory in quality improvement and patient safety education: Ascoping review.

IntroductionTheory plays an important role in education programming and research. However, its use in quality improvement and patient safety education has yet to be fully characterized. The authors undertook a scoping review to examine the use of theory in quality improvement and patient safety education.MethodsEligible articles used theory to inform the design or study of a quality improvement or patient safety curriculum. The authors followed scoping review methodology and searched articles referenced in 20 systematic reviews of quality improvement and patient safety education, or articles citing one of these reviews, and hand searched eligible article references. Data analysis involved descriptive and interpretive summaries of theories used and the perspectives the theories offered.ResultsEligibility criteria were met by 28 articles, and 102 articles made superficial mention of theory. Eligible articles varied in professional group, learning stage and journal type. Theories fell into two broad categories: learning theories (n = 20) and social science theories (n = 11). Theory was used in the design (n = 12) or study (n = 17) of quality improvement and patient safety education. The range of theories shows the opportunity afforded by using more than one type of theory.DiscussionTheory can guide decisions regarding quality improvement and patient safety education practices or play a role in selecting a methodology or lens through which to study educational processes and outcomes. Educators and researchers should make deliberate choices around the use of theory that relates to aspects of an educational program that they seek to illuminate.Supplementary InformationThe online version of this article (10.1007/s40037-021-00686-5) contains supplementary material, which is available to authorized users.

Impact of Nurse Practitioners and Nursing Education on COVID-19 Pandemics: Innovative Strategies of Authentic Technology-Integrated Clinical Simulation

Taiwan Nurses Association and the International Council of Nurses recognize nurse practitioners (NPs) as advanced-practice nurses. A total of 11,266 registered nurses held NP certificates in April 2021 in Taiwan (Tsay, 2021). While international organizations recognize NPs with graduate degrees, over 85% of NPs in Taiwan hold a bachelor degree only. Tsay and Wang (2007) emphasized that NP education in Taiwan should be in step with international trends. Therefore, nursing schools must recruit PhD faculty who hold NP certificates. In addition, complicated and simulation-based learning procedures and teaching plans must be incorporated into the graduate curriculum and clinical practicum to promote the clinical reasoning competences and advanced nursing capabilities of NPs in light of professional training, qualifying examinations, and occupational practice. With the evolution of virtual technology, the strategies for teaching core competences in nursing education have shifted from traditional classroom lectures to online format simulation. Recently, scholars have begun using authentic technology-enhanced clinical simulation to develop and integrate nursing competence to reconceptualize the gap between theory and practice (Weeks et al., 2019). It is increasingly important to teach patient safety, clinical reasoning, and decision-making skills to nursing students using the assistive methods of clinical simulation technology (Aebersold, 2016; Johnsen et al., 2016). Since 2019, the COVID-19 pandemic has had a global impact. In May 2021, clinical practice settings and university campuses in Taiwan were closed following the announcement of a nationwide, level-3 epidemic alert. The Ministry of Education and Taiwan Nurses Association approved the replacement of up to 50% of clinical practicum hours with alternative learning activities. Therefore, faculties require innovative strategies to teach requisite skills and deliver clinical practica online. The faculty members of California State University use virtual clinical education and standardized patient-based telehealth simulations (Shea & Rovera, 2021). In Taiwan, there is a lack of studies in the literature examining the effect of replacing 50% of traditional face-to-face clinical activities with educational alternatives. Prior survey results have demonstrated the efficacy of transitioning to virtual clinical experiences in an online environment for undergraduate and graduate students (Fogg et al., 2020). Moreover, a systematic review provided evidence that virtual simulations support learning outcomes (Foronda et al., 2020). To promote clinical-reasoning competence in graduate students with NP certificates and prepare alternative, virtual-based teaching plans to meet the remaining clinical hours required of students, Fooyin University's School of Nursing has recently established the multi-functional iNursing-Innovative Learning Center. The hardware devices provide interactive virtual patients with character creator 3D, augmented realty (AR) hospital, operating room, intensive care unit, and virtual reality (VR) simulation plans for different nursing divisions as well as editors of electronic book and AR/VR teaching plans. The simulation plans include commercial products and self-design produced by well-trained faculty members. A group of seeding faculty members supported by the Ministry of Education's Higher Education Sprout Project and university funding was tapped to develop a large number of virtual simulation plans. In addition, when developing virtual simulation, it is necessary to follow teaching team discussion and learning objective setting procedures, pre-brief teachers and students, enact plans, conduct debriefing, and collect and evaluate data to explore the learning and teaching process and outcomes (Verkuyl et al., 2021). The nursing clinical practicum continues to be impacted by the ongoing COVID-19 pandemic. In a further study, nursing academic faculty cooperated with clinical preceptors to develop and design education strategies using authentic technology-integrated clinical simulations to promote advanced and comprehensive care competences in nurse practitioners.