CMS Transportable Simulation-Based Training Curriculum in Patient Safety

Abstract Introduction Patient safety has received significant press and funding for advancement since the landmark Institute of Medicine report in 1999. However, the difficult process of fostering cultural change in medicine requires that new educational methods, curricula, and assessment tools be i...

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Main Authors: Marc Shapiro, Leo Kobayashi, Frank Overly, David Lindquist, Pat Croskerry, Christopher Beach, Ravi Behara, Eric Eisenberg, Lexa Murphy, Shawna Perry, Mary Vanderhoef, Robert Wears, Cherri Hogbood, Kavita Babu
Format: Article
Language:English
Published: Association of American Medical Colleges 2009-12-01
Series:MedEdPORTAL
Subjects:
Online Access:http://www.mededportal.org/doi/10.15766/mep_2374-8265.592
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author Marc Shapiro
Leo Kobayashi
Frank Overly
David Lindquist
Pat Croskerry
Christopher Beach
Ravi Behara
Eric Eisenberg
Lexa Murphy
Shawna Perry
Mary Vanderhoef
Robert Wears
Cherri Hogbood
Kavita Babu
author_facet Marc Shapiro
Leo Kobayashi
Frank Overly
David Lindquist
Pat Croskerry
Christopher Beach
Ravi Behara
Eric Eisenberg
Lexa Murphy
Shawna Perry
Mary Vanderhoef
Robert Wears
Cherri Hogbood
Kavita Babu
author_sort Marc Shapiro
collection DOAJ
description Abstract Introduction Patient safety has received significant press and funding for advancement since the landmark Institute of Medicine report in 1999. However, the difficult process of fostering cultural change in medicine requires that new educational methods, curricula, and assessment tools be instituted at the earliest possible opportunity in medical education. Simulation offers a method to assess performance in low-frequency but high-risk situations in an environment closely replicating daily clinical work. Methods This modular package is a transportable simulation-based curriculum designed to provide patient safety and human factors training for health care providers and learners. The curriculum identifies certain ACGME-designated competency domains as being amenable to assessment by simulation. Separately, probe instruments meant to evaluate learner retention of module teaching points and to serve in larger-scale validation studies are specified. The curriculum presents these competency domains and investigative probes within each module's simulation case. The specific areas of focus are (1) clinician recognition of cognitive biases that lead to diagnostic error, (2) teamwork in emergent resuscitations, (3) authority gradients and cultural change (e.g., medical error disclosure), and (4) transitions in care. These elements have repeatedly been determined to contribute significantly to preventable medical error. Using PowerPoint slide shows and simulation cases, the component modules are designed to educate and evaluate health care providers of all levels in these critical patient safety issues. Clinical content of the included simulation cases covers (1) difficult airway management, (2) multipatient multitrauma management, (3) toxic acetaminophen ingestion and antidote complications, and (4) contrast anaphylactoid reaction. Through these participatory learning exercises, the curriculum attempts to promote and ingrain a culture of safety in the participants. Results Participant surveys and performance data of residents and teams were collected and uniformly showed high levels of acceptance and satisfaction with simulation-based medical education. Although measurement of actual improvement in patient outcomes was not possible, surrogate measures of performance were collected. Discussion In a program jointly supported by this project and the study site's risk management department, pediatric residents demonstrated improvement in crucial skills such as airway and resuscitation management, team performance, and overall competency. The modules have been compiled into a stand-alone package for dissemination as a ready reference and for future collaborative research efforts.
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spelling doaj.art-acb12a859c2b48a3b3b9a24d11243afd2022-12-22T04:13:05ZengAssociation of American Medical CollegesMedEdPORTAL2374-82652009-12-01510.15766/mep_2374-8265.592CMS Transportable Simulation-Based Training Curriculum in Patient SafetyMarc Shapiro0Leo Kobayashi1Frank Overly2David Lindquist3Pat Croskerry4Christopher Beach5Ravi Behara6Eric Eisenberg7Lexa Murphy8Shawna Perry9Mary Vanderhoef10Robert Wears11Cherri Hogbood12Kavita Babu131 The Warren Alpert Medical School of Brown University2 The Waren Alpert Medical School of Brown University3 The Warren Alpert Medical School of Brown University4 The Warren Alpert Medical School of Brown University5 Dalhousie University Faculty of Medicine6 Northwestern University: The Feinberg School of Medicine7 College of Business: Florida Atlantic University8 Department of Communication: University of South Florida9 Department of Communication: Depaul University10 University of Florida College of Medicine11 University of Florida Health Science Center Jacksonville12 University of Florida Health Science Center Jacksonville13 University of North Carolina-Chapel Hill School of Medicine14 University of Massachusetts Medical SchoolAbstract Introduction Patient safety has received significant press and funding for advancement since the landmark Institute of Medicine report in 1999. However, the difficult process of fostering cultural change in medicine requires that new educational methods, curricula, and assessment tools be instituted at the earliest possible opportunity in medical education. Simulation offers a method to assess performance in low-frequency but high-risk situations in an environment closely replicating daily clinical work. Methods This modular package is a transportable simulation-based curriculum designed to provide patient safety and human factors training for health care providers and learners. The curriculum identifies certain ACGME-designated competency domains as being amenable to assessment by simulation. Separately, probe instruments meant to evaluate learner retention of module teaching points and to serve in larger-scale validation studies are specified. The curriculum presents these competency domains and investigative probes within each module's simulation case. The specific areas of focus are (1) clinician recognition of cognitive biases that lead to diagnostic error, (2) teamwork in emergent resuscitations, (3) authority gradients and cultural change (e.g., medical error disclosure), and (4) transitions in care. These elements have repeatedly been determined to contribute significantly to preventable medical error. Using PowerPoint slide shows and simulation cases, the component modules are designed to educate and evaluate health care providers of all levels in these critical patient safety issues. Clinical content of the included simulation cases covers (1) difficult airway management, (2) multipatient multitrauma management, (3) toxic acetaminophen ingestion and antidote complications, and (4) contrast anaphylactoid reaction. Through these participatory learning exercises, the curriculum attempts to promote and ingrain a culture of safety in the participants. Results Participant surveys and performance data of residents and teams were collected and uniformly showed high levels of acceptance and satisfaction with simulation-based medical education. Although measurement of actual improvement in patient outcomes was not possible, surrogate measures of performance were collected. Discussion In a program jointly supported by this project and the study site's risk management department, pediatric residents demonstrated improvement in crucial skills such as airway and resuscitation management, team performance, and overall competency. The modules have been compiled into a stand-alone package for dissemination as a ready reference and for future collaborative research efforts.http://www.mededportal.org/doi/10.15766/mep_2374-8265.592SafetyAirway ManagementMulti-TraumaCognitive BiasMulti-PatientAcetaminophen Overdose
spellingShingle Marc Shapiro
Leo Kobayashi
Frank Overly
David Lindquist
Pat Croskerry
Christopher Beach
Ravi Behara
Eric Eisenberg
Lexa Murphy
Shawna Perry
Mary Vanderhoef
Robert Wears
Cherri Hogbood
Kavita Babu
CMS Transportable Simulation-Based Training Curriculum in Patient Safety
MedEdPORTAL
Safety
Airway Management
Multi-Trauma
Cognitive Bias
Multi-Patient
Acetaminophen Overdose
title CMS Transportable Simulation-Based Training Curriculum in Patient Safety
title_full CMS Transportable Simulation-Based Training Curriculum in Patient Safety
title_fullStr CMS Transportable Simulation-Based Training Curriculum in Patient Safety
title_full_unstemmed CMS Transportable Simulation-Based Training Curriculum in Patient Safety
title_short CMS Transportable Simulation-Based Training Curriculum in Patient Safety
title_sort cms transportable simulation based training curriculum in patient safety
topic Safety
Airway Management
Multi-Trauma
Cognitive Bias
Multi-Patient
Acetaminophen Overdose
url http://www.mededportal.org/doi/10.15766/mep_2374-8265.592
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