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Presentation by Dr James Edwards
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Team Health Right Start Program Showcase27 February 2012
1
Right Start Forum
Preparing for Safe Practice as an Intern
(PSPI Program)
Presenter:
Dr James Edwards
Project Partners:
Sydney Medical School
Northern Sydney Local Health District
Sydney Local Health District
Team Health Right Start Program Showcase27 February 2012
2
Faculty
Merrilyn Walton: Professor of Medical Education (Patient Safety) School of Public Health, Sydney Medical School
Stewart Dunn: Professor of Psychological Medicine, Northern Clinical School
James Edwards: Emergency Physician, Royal Prince Alfred Hospital
Kar-Soon Lim: Senior Lecturer Anaesthesia, Concord Clinical School
Vasi Naganathan: Ass. Professor Medicine, Concord Clinical School, Centre for Education and Research on Ageing (CRGH)
Leonnie Watterson: Clinical Associate Professor, Anaesthesia, Northern Clinical School, Director
Jennifer-Smith Merry: Research Fellow, School of Public Health
Susan McKenzie, Clinical Lecturer, Sydney Medical School
Clare Richmond: Emergency Physician, Simulation Fellow, RNSH, RPAH
Gillian Nisbet, PhD candidate & project manager
Barbara Cassidy, Educational design instructor
Beth Vogelzang (Acting) Nursing Unit Manager, Concord Repatriation General Hospital
Evelyn Dalton Manager Clinical Simulation Laboratory/Academic Sydney Nursing School
Registrars and resident medical officers, actors, volunteer nurses.
Team Health Right Start Program Showcase27 February 2012
3
Introduction & Background
July phenomenon Increased errors occur with new house staff at the
beginning of the academic year Inaba K, et al., Complications and death at the start of the new
academic year: Is there a July phenomenon. The Journal of Trauma: Injury Infection and Critical care, 2010. 68(1): p. 19-22.
Haller G, et al., Rate of undesirable events at the beginning of academic year :retrospective cohort study. BMJ, 2009: p. 339:b3974.
January phenomenon Hilmer S, et al., Do medical courses adequately prepare interns for safe
and effective prescribing in New South Wales public hospitals? Internal Medicine Journal, 2009. 39: p. 428-34.
Team Health Right Start Program Showcase27 February 2012
4
Aim & Methods
Program Aim: Reduce adverse events or the potential for adverse
events for patients being treated by interns during their first months of employment.
Learning Outcomes: Demonstrate knowledge of and be confident in
situations that have the potential to harm a patient Identify the ‘red flag’ situations Know when to seek assistance Act appropriately to avoid an adverse event.
Team Health Right Start Program Showcase27 February 2012
5
Aim & Methods
Program designed around 6 theme areas: Clinical challenges – case management problems Procedures – skills for discrete procedures Organisational skills – clinical clerking – working safely and
effectively within the system The deteriorating patient – clinical emergencies Interactive – patient doctor, colleague communication Self-management – behaviours directed as self-regulation
and professionalism
5 Day experiential program for pre-intern medical students:
Case-based learning; simulations; workshops; role plays
Team Health Right Start Program Showcase27 February 2012
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Results
Process evaluation 37 Pre-internship medical students 70% of participants rated Program 8 out of 10 or above Clinically focused sessions well received:
Active participation - time for practice and questions Based on real cases/ real mistakes – met immediate needs of
participants Participants ‘put in situation’ – i.e. it could have been them
that had made the mistake
All but 4 participants indicated that all final year medical students would benefit from such a course
Impact evaluation - ongoing
Outline your project’s results drawing on process (logistics, implementation), as well as qualitative and quantitative data analysis findings
Team Health Right Start Program Showcase27 February 2012
7Conclusions & Lessons LearnedPSPI program fills the gap in transition from student
to practitioner
Maintain clinical focus on avoiding adverse events: Retain the most effective and efficient learning methods Integrate communication skills development into clinical
case scenarios rather than a separate session Provide opportunities for individual feedback on
performance
Clinician teachers are prepared and include Clinician educators with recent graduate experience Experienced clinicians with teaching and supervisory
responsibilities
Team Health Right Start Program Showcase27 February 2012
8
Where to from here?
Finalise the PSPI Curriculum Guide incorporating: Principles and background for content covered and
teaching strategies adopted (i.e. how to teach) Comprehensive description of topics, resources and
facilitator actions
Develop the PSPI Facilitator Training Program (How to teach)
Make available the PSPI program to all medical schools
Continue research plan to evaluate the longer term impact of PSPI Program
Opportunities for IPL??