Driven to distraction

a prospective controlled study of a simulated ward round experience to improve patient safety teaching for medical students

Ian Thomas*, Laura Nicol, Luke Regan, Jennifer Cleland, Drieka Maliepaard, Lindsay Clark, Kenneth Walker, John Duncan

*Corresponding author for this work

Research output: Contribution to journalArticle

17 Citations (Scopus)
5 Downloads (Pure)

Abstract

Background Distraction and interruption are endemic in the clinical environment and contribute to error. This study assesses whether simulation-based training with targeted feedback can improve undergraduate management of distractions and interruptions to reduce error-making.

Design A prospective non-randomised controlled study.

Methods 28 final year medical students undertook a simulated baseline ward round. 14 students formed an intervention group and received immediate feedback on distractor management and error. 14 students in a control group received no feedback. After 4 weeks, students participated in a post-intervention ward round of comparable rigour. Changes in medical error and distractor management between simulations were assessed with Mann-Whitney U tests using SPSS V.21.

Results At baseline, error rates were high. The intervention group committed 72 total baseline errors (mean of 5.1 errors/student; median 5; range 3-7). The control group exhibited a comparable number of errors-with a total of 76 observed (mean of 5.4 errors/student; median 6; range 4-7). Many of these errors were life-threatening. At baseline distractions and interruptions were poorly managed by both groups. All forms of simulation training reduced error-making. In the intervention group the total number of errors post-intervention fell from 72 to 17 (mean 1.2 errors/student; median 1; range 0-3), representing a 76.4% fall (p

Conclusions Medical students are not inherently equipped to manage common ward-based distractions to mitigate error. These skills can be taught-with simulation and feedback conferring the greatest benefit. Curricular integration of simulated ward round experiences is recommended.

Original languageEnglish
Pages (from-to)154-161
Number of pages8
JournalBMJ Quality & Safety
Volume24
Issue number2
Early online date24 Nov 2014
DOIs
Publication statusPublished - Feb 2015

Keywords

  • operating-room
  • performance
  • interruptions
  • stress
  • errors
  • impact
  • task
  • care

Cite this

Driven to distraction : a prospective controlled study of a simulated ward round experience to improve patient safety teaching for medical students. / Thomas, Ian; Nicol, Laura; Regan, Luke; Cleland, Jennifer; Maliepaard, Drieka; Clark, Lindsay; Walker, Kenneth; Duncan, John.

In: BMJ Quality & Safety, Vol. 24, No. 2, 02.2015, p. 154-161.

Research output: Contribution to journalArticle

@article{54e43c3664384c5aa2d04993c0ee3aa5,
title = "Driven to distraction: a prospective controlled study of a simulated ward round experience to improve patient safety teaching for medical students",
abstract = "Background Distraction and interruption are endemic in the clinical environment and contribute to error. This study assesses whether simulation-based training with targeted feedback can improve undergraduate management of distractions and interruptions to reduce error-making.Design A prospective non-randomised controlled study.Methods 28 final year medical students undertook a simulated baseline ward round. 14 students formed an intervention group and received immediate feedback on distractor management and error. 14 students in a control group received no feedback. After 4 weeks, students participated in a post-intervention ward round of comparable rigour. Changes in medical error and distractor management between simulations were assessed with Mann-Whitney U tests using SPSS V.21.Results At baseline, error rates were high. The intervention group committed 72 total baseline errors (mean of 5.1 errors/student; median 5; range 3-7). The control group exhibited a comparable number of errors-with a total of 76 observed (mean of 5.4 errors/student; median 6; range 4-7). Many of these errors were life-threatening. At baseline distractions and interruptions were poorly managed by both groups. All forms of simulation training reduced error-making. In the intervention group the total number of errors post-intervention fell from 72 to 17 (mean 1.2 errors/student; median 1; range 0-3), representing a 76.4{\%} fall (pConclusions Medical students are not inherently equipped to manage common ward-based distractions to mitigate error. These skills can be taught-with simulation and feedback conferring the greatest benefit. Curricular integration of simulated ward round experiences is recommended.",
keywords = "operating-room, performance, interruptions, stress, errors, impact, task, care",
author = "Ian Thomas and Laura Nicol and Luke Regan and Jennifer Cleland and Drieka Maliepaard and Lindsay Clark and Kenneth Walker and John Duncan",
note = "Acknowledgments The authors would like to thank The Clinical Skills Managed Educational Network for its financial support, without which this research would not have taken place. Ethics approval Ethics approval for this research study was sought and granted from the University of Aberdeen's College and Ethics Research Board (Application No. CERB/2013/1/837). All participants in the study gave informed written consent before taking part in the research. Data sharing statement The research was carried out as part of a Masters in Medical Education degree. The Masters dissertation includes extensive study data—whereas this article contains the most pertinent quantitative data. The full Masters thesis is available from the University of Dundee",
year = "2015",
month = "2",
doi = "10.1136/bmjqs-2014-003272",
language = "English",
volume = "24",
pages = "154--161",
journal = "BMJ Quality & Safety",
issn = "2044-5415",
publisher = "BMJ Publishing Group",
number = "2",

}

TY - JOUR

T1 - Driven to distraction

T2 - a prospective controlled study of a simulated ward round experience to improve patient safety teaching for medical students

AU - Thomas, Ian

AU - Nicol, Laura

AU - Regan, Luke

AU - Cleland, Jennifer

AU - Maliepaard, Drieka

AU - Clark, Lindsay

AU - Walker, Kenneth

AU - Duncan, John

N1 - Acknowledgments The authors would like to thank The Clinical Skills Managed Educational Network for its financial support, without which this research would not have taken place. Ethics approval Ethics approval for this research study was sought and granted from the University of Aberdeen's College and Ethics Research Board (Application No. CERB/2013/1/837). All participants in the study gave informed written consent before taking part in the research. Data sharing statement The research was carried out as part of a Masters in Medical Education degree. The Masters dissertation includes extensive study data—whereas this article contains the most pertinent quantitative data. The full Masters thesis is available from the University of Dundee

PY - 2015/2

Y1 - 2015/2

N2 - Background Distraction and interruption are endemic in the clinical environment and contribute to error. This study assesses whether simulation-based training with targeted feedback can improve undergraduate management of distractions and interruptions to reduce error-making.Design A prospective non-randomised controlled study.Methods 28 final year medical students undertook a simulated baseline ward round. 14 students formed an intervention group and received immediate feedback on distractor management and error. 14 students in a control group received no feedback. After 4 weeks, students participated in a post-intervention ward round of comparable rigour. Changes in medical error and distractor management between simulations were assessed with Mann-Whitney U tests using SPSS V.21.Results At baseline, error rates were high. The intervention group committed 72 total baseline errors (mean of 5.1 errors/student; median 5; range 3-7). The control group exhibited a comparable number of errors-with a total of 76 observed (mean of 5.4 errors/student; median 6; range 4-7). Many of these errors were life-threatening. At baseline distractions and interruptions were poorly managed by both groups. All forms of simulation training reduced error-making. In the intervention group the total number of errors post-intervention fell from 72 to 17 (mean 1.2 errors/student; median 1; range 0-3), representing a 76.4% fall (pConclusions Medical students are not inherently equipped to manage common ward-based distractions to mitigate error. These skills can be taught-with simulation and feedback conferring the greatest benefit. Curricular integration of simulated ward round experiences is recommended.

AB - Background Distraction and interruption are endemic in the clinical environment and contribute to error. This study assesses whether simulation-based training with targeted feedback can improve undergraduate management of distractions and interruptions to reduce error-making.Design A prospective non-randomised controlled study.Methods 28 final year medical students undertook a simulated baseline ward round. 14 students formed an intervention group and received immediate feedback on distractor management and error. 14 students in a control group received no feedback. After 4 weeks, students participated in a post-intervention ward round of comparable rigour. Changes in medical error and distractor management between simulations were assessed with Mann-Whitney U tests using SPSS V.21.Results At baseline, error rates were high. The intervention group committed 72 total baseline errors (mean of 5.1 errors/student; median 5; range 3-7). The control group exhibited a comparable number of errors-with a total of 76 observed (mean of 5.4 errors/student; median 6; range 4-7). Many of these errors were life-threatening. At baseline distractions and interruptions were poorly managed by both groups. All forms of simulation training reduced error-making. In the intervention group the total number of errors post-intervention fell from 72 to 17 (mean 1.2 errors/student; median 1; range 0-3), representing a 76.4% fall (pConclusions Medical students are not inherently equipped to manage common ward-based distractions to mitigate error. These skills can be taught-with simulation and feedback conferring the greatest benefit. Curricular integration of simulated ward round experiences is recommended.

KW - operating-room

KW - performance

KW - interruptions

KW - stress

KW - errors

KW - impact

KW - task

KW - care

U2 - 10.1136/bmjqs-2014-003272

DO - 10.1136/bmjqs-2014-003272

M3 - Article

VL - 24

SP - 154

EP - 161

JO - BMJ Quality & Safety

JF - BMJ Quality & Safety

SN - 2044-5415

IS - 2

ER -