Exploration of students’ reaction in medical error events and the impact of personalized training on the speaking-up behavior in medical error events

Yi Chun Chen, S. Barry Issenberg, Yu Jui Chiu, Hui Wen Chen, Zachary Issenberg, Yi No Kang, Che Wei Lin, Jen Chieh Wu

研究成果: 雜誌貢獻文章同行評審

摘要

Background: The ability of medical students to speak up before a medical error occurs is a timely and necessary interaction to prevent potential patient harm. As it may be crucial to improve patient safety, we explored how medical students react to a medical error and provided them appropriate training regarding speaking up about medical issues. Methods: A quasi-experimental study was conducted in Taiwan involving 153 medical students who participated in a speaking-up simulation course. They were divided into two groups. The first group participated in a non-life-threatening scenario before the intervention, followed by a personalized debriefing session, then a life-threatening scenario after the intervention. The second group participated in a life-threatening scenario before the intervention, followed by a personalized debriefing session, then a non-life-threatening scenario after the intervention. Students also completed patient safety attitude survey. Results: During the preintervention scenario, the overall medical students’ speaking-up rate to medical error was 45.1%. The speaking-up rate of medical students in life-threatening scenario was significantly higher than the rate in non-life-threatening scenario before the intervention (64.6% vs 24.3%, p < 0.001). After personalized debriefing, the speaking-up rate to medical errors was significantly improved both in life-threatening scenarios (95.9%, p < 0.001) and in non-life-threatening scenarios (100%, p < 0.001). Male medical students had significantly higher speaking-up rates than female students in life-threatening scenario (76.2% vs 51.4%, p = 0.02). On post-intervention surveys, students provided several reasons for their likelihood of speaking up or remaining silent during a medical error event. Conclusions: Medical students’ rate of speaking-up to medical error was higher in a simulated life-threatening scenario than in a simulated non-life-threatening scenario. Faculty-led personalized debriefing can facilitate medical students’ adoption of communication strategies to speak up more in medical error events. Educators should also consider gender differences when they design effective assertive communication courses. Practice points Personalized assertive communication training could improve medical students speaking up behavior in the event of medical error. The medical students have a higher rate of speaking up in the life-threatening scenario compared to the non-life-threatening scenario. Male students had a higher rate of speaking up than females in the life-threatening scenario but not in the non-life-threatening scenario.
原文英語
期刊Medical Teacher
DOIs
出版狀態接受/付印 - 2022

ASJC Scopus subject areas

  • 教育

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