Blazing a new trail in medical education, third-year students participated in the Miller School's first dedicated patient safety immersion course before assuming their clinical duties last month.
The inaugural week-long course, which began June 14 at the University of Miami-Jackson Memorial Hospital Center for Patient Safety, engaged 150 medical students in simulation exercises designed to teach patient safety skills, such as teamwork, communication, professionalism, and hand hygiene.
In exact replicas of examination rooms and an ICU, students interacted, both individually and in teams, with patient actors experiencing heart palpitations, breathing difficulties, over-sedation, and domestic violence. Through these encounters and subsequent debriefings, students learned how to think critically when facing complex situations and how to best interact with patients, nurses, colleagues, and superiors.
"We felt that it was important to bring the same experience to our medical school students that we have provided to the Jackson Memorial Hospital interns for the past five years,'' said David J. Birnbach, M.D., M.P.H., professor of anesthesiology and public health, associate dean for patient safety and director of the UM-JMH Center for Patient Safety. "When we asked if medical schools were teaching patient safety, communication skills, and teamwork, the answer was typically ‘no' or ‘not really.' So, we decided that UM would forge new ground and provide a separate patient safety course geared toward medical students. With this in mind, we conceived of a unique set of hands-on encounters to dramatize the importance of core patient safety practices."
The week-long program consists of lectures, web-based modules, team-training exercises, and simulation activities. Originating from a pilot program held last year as part of the Doctoring course, it was expanded into a separate course and moved to the week before third-year students begin their clinical rotations.
In addition to their training at the center, students played various games in small groups to illustrate the importance of leadership, communication and teamwork.
"This was a fun way to show how you have to adapt quickly in a team,'' third-year student Quinton Sparrow said after completing the exercise. "There is a high likelihood that we will be thrown together during a medical crisis with people we may not know or who we have not worked with before, and this game taught us how to identify a leader, delegate specific tasks, and organize ourselves quickly and effectively."
Alex Mechaber, M.D., senior associate dean for undergraduate medical education, said the course evolved from the Miller School's commitment to providing safe and effective care for patients. "For years, we have been teaching medical students about key patient safety issues,'' he said. "This year, we implemented a new course at the start of the clinical clerkships that would provide students with the requisite knowledge, skills, behaviors and attitudes to deliver safe patient care as well as identify and solve patient safety problems. And, we were thrilled to collaborate with the Center for Patient Safety."
To reinforce their patient safety training, students also will end their third year with a corresponding Objective Structured Clinical Examination (OSCE). "In this way," Dr. Birnbach explained, "patient safety messages are introduced at an earlier stage of medical education and reinforced throughout the continuum of their medical education with lectures, visits to the Center for Patient Safety and OSCEs. Our goal is to build awareness early, and to reinforce these practices until they become second nature. This is an innovative approach and promotes proper habits for students and teachers alike."
Tyler Bevins, now a fourth-year student, said he found the simulated scenarios and the corresponding OSCE invaluable. "Errors happen because there is poor communication between doctors and nurses, and a doctor typically has only a few minutes to spend with a patient,'' Bevins said. "The scenarios at the Center highlighted our weaknesses and the importance of having adequate safeguards in the system. I am confident that I did well in the patient safety OSCE, and I definitely integrated what I learned at the Center for Patient Safety into today's experience and, most importantly, into my daily clinical practice."