Patient safety: what’s being taught at medical schools? Professor Jennifer Cleland John Simpson Chair of Medical Education, University of Aberdeen Chair of Council, Association for the Study of Medical Education (ASME)

Overview “What’s being taught?” - guidance Examples of patient safety teaching and assessment National initiatives Innovative teaching and learning

Outcomes 2: The doctor as practitioner Robust assessment systems Communicate effectively with patients and colleagues in a medical context Prescribe drugs safely, effectively and economically Use information effectively in a medical context Outcomes 3: The doctor as a professional Behave according to ethical and legal principles Working effectively in a team Protect patients and improve care Domain 1: Patient safety Supervision Ensuring students are working within their competences

Eleven topics 1. What is patient safety? 2. What is human factors? 3. Understanding systems and the impact of complexity on patient care 4. Being an effective team player 5. Understanding and learning from error 6. Understanding and managing clinical risk 7. Introduction to methods for quality improvement 8. Engaging with patients and carers 9. Minimizing infection through improved infection control 10. Patient safety and invasive procedures 11. Introduction to medication safety

Infection control Formal teaching on infection control on in all medical school curricula e.g., Hand hygiene Safe sharps practice Needlestick accident procedures Risks of spreading infection if unwell clearly explained Getting and staying vaccinated

Communicating with patients and the team Communication with patients covered very well in medical school curricula Vertical programmes - simple to complex communication

Communicating with patients and the team Communication with patients covered very well in medical school curricula Vertical programmes - simple to complex communication Team communication Evidence suggests best taught via structured simulated experiences and/or observational experiences in practice settings Often complex - most usefully taught in later/clinical years (?) Role modelling critical

Prescribing

Prescribing Safety Assessment Closely blueprinted to Tomorrow’s Doctors 3 A 2-hour assessment covering the following domains: prescribing prescription review planning management providing information about medicines calculation skills adverse drug reactions drug monitoring data interpretation Piloted with 29 schools in 2013 Will run nationally in 2014 Expectation that students at all UK medical schools will take – and pass – the PSA during their final year

Aberdeen Edinburgh Exeter Liverpool Swansea Examples of innovative teaching and learning

Aberdeen: Linking with NHS initiatives NHS staff teaching e.g., risk management Role modelling Credibility Patient safety integrated into student workplace experiences e.g., Safety briefings Handover Hospital at night Communicating a culture where clinical and other NHS staff have ownership of patient safety

Smith, Tallentire, Cameron and Wood. Pre-prescribing: a safe way to learn at work? The Clinical Teacher, 2012; 9:

Exeter In the later years, prescribing is a strong curriculum theme, and there is a formative prescribing competency in Year 4 There is also a “management” SSC where students take a focussed service problem, identify improvements and make recommendations leading to safety and/or service improvement

Liverpool's Patient Safety Programme Year 5 students are required to complete a series of practical clinical assessments and on-line theoretical tests covering the required practical competencies in Tomorrow’s Doctors (2009) and prescribing The results from this are considered (at 5-10 points in the year) alongside written comments about a student’s knowledge, skills and attitudes derived from medical/surgical and nursing colleagues in the workplace

Swansea

My thanks to: Rona Patey, Aberdeen Karen Mattick, Exeter Judy McKimm, Swansea David Taylor, Liverpool