Teaching Students How to Improve Safety and Quality in Two Children's Hospitals: Building a Pediatric Clerkship Patient Safety and Quality Experience.

This report describes a novel method to enhance medical student understanding of systems-based practice and patient safety through experiential learning, assessing the perceived value of student-identified patient safety and systems vulnerabilities, and their proposed interventions at academic children's hospitals.

Using interprofessional medication management simulations to impact student attitudes toward teamwork to prevent medication errors.

BACKGROUND: We developed and implemented a project incorporating ACPE Standard 11 and all Core IPEC competencies at a public University located at a medical center. The project was a collaboration between the colleges of nursing, pharmacy, and medicine at a distance campus location. INTERPROFESSIONAL EDUCATION ACTIVITY: Our Interprofessional Education Activity, which targeted all three elements of ACPE Standard 11, provided TeamSTEPPS® training followed by four medical error simulations. A debriefing took place after each scenario within a team as well as with all four groups following each simulation session. The Teamwork Attitudes Questionnaire (TTAQ) was used to evaluate the activity. DISCUSSION: Findings from our interprofessional education activity indicate that while students entered the activity already perceiving teamwork as a positive aspect of safe care delivery, significant improvement in attitudes post training toward specific team constructs was seen across all five domains. The project helped inform the structure of a replication of this effort that is currently underway, with a focus on embedding it in the curricula of all three programs (medicine, pharmacy, and nursing) across campuses. IMPLICATIONS: In summary, working collaboratively in a team while being exposed to a series of medication management scenarios enhances teamwork attitudes as well as potentially improving performance. Based on the positive initial results, plans have begun to extend the experience to other campuses and include a wider group of students.

Graduate medical education leadership development curriculum for program directors.

OBJECTIVE: Program director (PD) orientation to roles and responsibilities takes on many forms and processes. This article describes one institution's innovative arm of faculty development directed specifically toward PDs and associate PDs to provide institutional resources and information for those in graduate medical education leadership roles. METHODS: The designated institutional official created a separate faculty development curriculum for leadership development of PDs and associate PDs, modeled on the Association of American Medical Colleges-GRA (Group on Resident Affairs) graduate medical education leadership development course for designated institutional officials. It consists of monthly 90-minute sessions at the end of a working day, for new and experienced PDs alike, with mentoring provided by experienced PDs. We describe 2 iterations of the curriculum. To provide ongoing support a longitudinal curriculum of special topics has followed in the interval between core curriculum offerings. RESULTS: Communication between PDs across disciplines has improved. The broad, inclusive nature allowed for experienced PDs to take advantage of the learning opportunity while providing exchange and mentorship through sharing of lessons learned. The participants rated the course highly and education process and outcome measures for the programs have been positive, including increased accreditation cycle lengths. CONCLUSION: It is important and valuable to provide PDs and associate PDs with administrative leadership development and resources, separate from general faculty development, to meet their role-specific needs for orientation and development and to better equip them to meet graduate medical education leadership challenges. This endeavor provides a foundational platform for designated institutional official and PD interactions to work on program building and improvement.

A model to begin to use clinical outcomes in medical education.

The latest phase of the Accreditation Council for Graduate Medical Education (ACGME) Outcome Project challenges graduate medical education (GME) programs to select meaningful clinical quality indicators by which to measure trainee performance and progress, as well as to assess and improve educational effectiveness of programs. The authors describe efforts to measure educational quality, incorporating measurable patient-care outcomes to guide improvement. University of Florida College of Medicine-Jacksonville education leaders developed a tiered framework for selecting clinical indicators whose outcomes would illustrate integration of the ACGME competencies and their assessment with learning and clinical care. In order of preference, indicators selected should align with a specialty's (1) national benchmarked consensus standards, (2) national specialty society standards, (3) standards of local, institutional, or regional quality initiatives, or (4) top-priority diagnostic and/or therapeutic categories for the specialty, based on areas of high frequency, impact, or cost. All programs successfully applied the tiered process to clinical indicator selection and then identified data sources to track clinical outcomes. Using clinical outcomes in resident evaluation assesses the resident's performance as reflective of his or her participation in the health care delivery team. Programmatic improvements are driven by clinical outcomes that are shown to be below benchmark across the residents. Selecting appropriate clinical indicators-representative of quality of care and of graduate medical education-is the first step toward tracking educational outcomes using clinical data as the basis for evaluation and improvement. This effort is an important aspect of orienting trainees to using data for monitoring and improving care processes and outcomes throughout their careers.