Training Against Medical Error (TAME) Aim: Create VPs to train against Medical Error Avoidance of error Embed Virtual Patient Medical Error cases into Partner Country Curricula Transfer knowledge, skills, use super-regional networks to disseminate resources TAME – Training Against Medical Error 3 year project – started in October 2015, 1.5 years into it Funded by the EC Erasmus + programme 10 project partners – map, red to show error training Aims Face to face meetings – with workshops Website www.tame-project.org tjivram@sgul.ac.uk

Why? Why do we need VPs? (1 of 2) Provide students with an opportunity to develop and practice their clinical reasoning and decision making skills Provide students with an opportunity to learn by making mistakes Image Past studies haves how shown that students remember when things go wrong. Target avoidance of error by allowing student to make errors safely Develop clinical reasoning skills in practice based elements of medical education – Adapting existing traditional medical curricula to include interactive VPs - explore manage and solve problems while making mistakes Bridge the gap between university and real practice – in these countries they have traditional teaching methods and often it is difficult for the student to relate that back to real practice Allows students to think, make decision and see the consequences of those decisions “..we tried and tried and still killed the baby! I will never ever forget that....” 2

Error case writing training How? VP repurposing workshop Interactive PBL training PC adapted curriculum SGUL 6 paediatric cases (lot of info, reflect real life – when errors can happen) PCUs repurpose the cases to local language and healthcare culture Cases were tested with staff and students Deliver in PBL using OL Assessment instruments will be created – MCQs PCUs will create 6 cases in a new subject area and implement within their clinical curriculum For all training was provided – explain images Error case writing training Case review training

Evaluation TUTOR (57) experience survey LEARNER Experience (1726)/motivation (248) survey TUTOR TRAINER (5) written interview Evaluation Quantitative and qualitative methods (MCQs, Interview questions) CASE implementation written interview CASE WRITER (adaptor) (30) written interview CASE WRITER (creator) written interview

Findings Tutor trainers Students are more active and interested Linear Branched n 809 917 While working on this case, I felt I had to make the same decisions a doctor would make in real life. 4.04 4.09 After completing this case I feel better prepared to care for a real life patient with this complaint. 4.24 4.25 Overall, working through this case was a worthwhile learning experience. 4.43 4.44 Tutor trainers Students are more active and interested Leads to the development of clinical thinking “this method of training using a virtual patient is very well merged into the system of medical education” Case adaption Differences in local culture and healthcare systems Experience in writing good cases Healthcare and terminology – differences in the term ‘partner’ difference in social care