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Evaluating the Clinical Learning Environment: Resident and Fellow Perceptions of Patient Safety Culture.

ABSTRACT: The Accreditation Council for Graduate Medical Education has begun to evaluate teaching institutions' learning environments with Clinical Learning Environment Review visits, including trainee involvement in institutions' patient safety and quality improvement efforts.We sought to address the dearth of metrics that assess trainee patient safety perceptions of the clinical environment.Using the Hospital Survey on Patient Safety Culture (HSOPSC), we measured resident and fellow perceptions of patient safety culture in 50 graduate medical education programs at 10 hospitals within an integrated health system. As institution-specific physician scores were not available, resident and fellow scores on the HSOPSC were compared with national data from 29?162 practicing providers at 543 hospitals.Of the 1337 residents and fellows surveyed, 955 (71.4%) responded. Compared with national practicing providers, trainees had lower perceptions of patient safety culture in 6 of 12 domains, including teamwork within units, organizational learning, management support for patient safety, overall perceptions of patient safety, feedback and communication about error, and communication openness. Higher perceptions were observed for manager/supervisor actions promoting patient safety and for staffing. Perceptions equaled national norms in 4 domains. Perceptions of patient safety culture did not improve with advancing postgraduate year.Trainees in a large integrated health system have variable perceptions of patient safety culture, as compared with national norms for some practicing providers. Administration of the HSOPSC was feasible and acceptable to trainees, and may be used to track perceptions over time.

SUBMITTER: Bump GM

PROVIDER: S-EPMC4507899 | biostudies-other | 2015 Mar

REPOSITORIES: biostudies-other

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Evaluating the Clinical Learning Environment: Resident and Fellow Perceptions of Patient Safety Culture.

Bump Gregory M GM Calabria Jaclyn J Gosman Gabriella G Eckart Catherine C Metro David G DG Jasti Harish H McCausland Julie B JB Itri Jason N JN Patel Rita M RM Buchert Andrew A

Journal of graduate medical education 20150301 1

<h4>Background</h4>The Accreditation Council for Graduate Medical Education has begun to evaluate teaching institutions' learning environments with Clinical Learning Environment Review visits, including trainee involvement in institutions' patient safety and quality improvement efforts.<h4>Objective</h4>We sought to address the dearth of metrics that assess trainee patient safety perceptions of the clinical environment.<h4>Methods</h4>Using the Hospital Survey on Patient Safety Culture (HSOPSC), ...[more]

PMID: 26217435

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Project description:BACKGROUND:Patient safety is an integral part of all health care specialties, including dentistry. Dental students are exposed to patient safety culture during their clinical training. The aim of this study was to evaluate the perception of female students enrolled in dental degrees and dental hygiene programs towards patient safety culture and to determine its associated factors at a Middle Eastern setting. METHODS:This is a cross sectional study, based on a self-administered, English language questionnaire distributed by convenience among female dental students enrolled in two major Colleges of dentistry in Riyadh, Saudi Arabia. Participants had fulfilled at least one year of clinical training. Sample characteristics included the specialty and years of clinical training. Student's perception was measured using the validated Safety Attitude Questionnaire (SAQ) that consists of 36 statements, distributed over six domains. Responses were rated on a five point Likert scale and the average positive response rate (APRR) was calculated. Binary logistic regression models were constructed to determine factors significantly associated with positive perceptions. RESULTS:The response rate of both student programs was 221/312(70.8%). Students of dental sciences and dental hygiene programs were 133(60.2%) and 88(39.8%) respectively. Almost 42% of students were in their 1st and 2nd years of clinical training. The APRR of: Team Work Climate domain was 54.4?±?28.0, Safety Climate domain was 51.4?±?29.7, Job Satisfaction domain was 64.5?±?33.8, Stress Recognition domain was 56.2?±?37.8, Perceived Management Support domain was 50.7?±?37.7, and Working conditions was 55.3?±?32.1. Female students in their 3rd and 4th year of clinical were adj.OR?=?2.3[1.3-4.0] times more likely to have positive perception regarding the team work climate domain when compared to 1st and 2nd year clinical students, P?=?0.005. At each of the six individual domains, the odds of having a positive perception were also significantly higher among dentistry students in comparison to dental hygiene students with a range of adj.OR 2.6-4.6. CONCLUSIONS:Apparently patient safety is a concern among female dental students enrolled in dental degree and dental hygiene programs. This requires more attention from the staff, dental college's leadership/management, and faculty/students. Perception of dental students towards patient safety culture is expected to improve with the increase of clinical training.

Project description:BackgroundIn response to the complexity, challenges, and slow pace of innovation, health care organizations are adopting interdisciplinary team approaches. Systems engineering, which is oriented to creating new, scalable processes that perform with higher reliability and lower costs, holds promise for driving innovation in the face of challenges to team performance. A patient safety learning laboratory (lab) can be an essential aspect of fostering interdisciplinary team innovation across multiple projects and organizations by creating an ecosystem focused on deploying systems engineering methods to accomplish process redesign.PurposeWe sought to identify the role and activities of a learning ecosystem that support interdisciplinary team innovation through evaluation of a patient safety learning lab.MethodsOur study included three participating learning lab project teams. We applied a mixed-methods approach using a convergent design that combined data from qualitative interviews of team members conducted as teams neared the completion of their redesign projects, as well as evaluation questionnaires administered throughout the 4-year learning lab.ResultsOur results build on learning theories by showing that successful learning ecosystems continually create alignment between interdisciplinary teams' activities, organizational context, and innovation project objectives. The study identified four types of alignment, interpersonal/interprofessional, informational, structural, and processual, and supporting activities for alignment to occur.ConclusionInterdisciplinary learning ecosystems have the potential to foster health care improvement and innovation through alignment of team activities, project goals, and organizational contexts.Practice implicationsThis study applies to interdisciplinary teams tackling multilevel system challenges in their health care organization and suggests that the work of such teams benefits from the four types of alignment. Alignment on all four dimensions may yield best results.

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Evaluating the Clinical Learning Environment: Resident and Fellow Perceptions of Patient Safety Culture.

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Evaluating the Clinical Learning Environment: Resident and Fellow Perceptions of Patient Safety Culture.

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