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Presentation 1 - Preparation for Safe Practice as an Intern
1 Right Start ForumPreparing for Safe Practice as an Intern (PSPI Program) Presenter: Dr James Edwards Project Partners: Sydney Medical School Northern Sydney Local Health District Sydney Local Health District Team Health Right Start Program Showcase 27 February 2012
2 Faculty Merrilyn Walton: Professor of Medical Jennifer-Smith Merry: Research Fellow, School of Education (Patient Safety) School of Public Public Health Health, Sydney Medical School Susan McKenzie, Clinical Lecturer, Sydney Medical Stewart Dunn: Professor of Psychological School Medicine, Northern Clinical School Clare Richmond: Emergency Physician, Simulation James Edwards: Emergency Physician, Royal Fellow, RNSH, RPAH Prince Alfred Hospital Gillian Nisbet, PhD candidate & project manager Kar-Soon Lim: Senior Lecturer Barbara Cassidy, Educational design instructor Anaesthesia, Concord Clinical School Beth Vogelzang (Acting) Nursing Unit Vasi Naganathan: Ass. Professor Manager, Concord Repatriation General Hospital Medicine, Concord Clinical School, Centre for Education and Research on Ageing (CRGH) Evelyn Dalton Manager Clinical Simulation Laboratory/Academic Sydney Nursing School Leonnie Watterson: Clinical Associate Professor, Anaesthesia, Northern Clinical Registrars and resident medical School, Director officers, actors, volunteer nurses. Team Health Right Start Program Showcase 27 February 2012
3Introduction & Background July phenomenon Increased errors occur with new house staff at the beginning of the academic year Inaba K, et al., Complications and death at the start of the new academic year: Is there a July phenomenon. The Journal of Trauma: Injury Infection and Critical care, 2010. 68(1): p. 19-22. Haller G, et al., Rate of undesirable events at the beginning of academic year :retrospective cohort study. BMJ, 2009: p. 339:b3974. January phenomenon Hilmer S, et al., Do medical courses adequately prepare interns for safe and effective prescribing in New South Wales public hospitals? Internal Medicine Journal, 2009. 39: p. 428-34. Team Health Right Start Program Showcase 27 February 2012
4Aim & Methods Program Aim: Reduce adverse events or the potential for adverse events for patients being treated by interns during their first months of employment. Learning Outcomes: Demonstrate knowledge of and be confident in situations that have the potential to harm a patient Identify the ‘red flag’ situations Know when to seek assistance Act appropriately to avoid an adverse event. Team Health Right Start Program Showcase 27 February 2012
5Aim & Methods Program designed around 6 theme areas: Clinical challenges – case management problems Procedures – skills for discrete procedures Organisational skills – clinical clerking – working safely and effectively within the system The deteriorating patient – clinical emergencies Interactive – patient doctor, colleague communication Self-management – behaviours directed as self-regulation and professionalism 5 Day experiential program for pre-intern medical students: Case-based learning; simulations; workshops; role plays Team Health Right Start Program Showcase 27 February 2012
6Results Process evaluation 37 Pre-internship medical students 70% of participants rated Program 8 out of 10 or above Clinically focused sessions well received: Active participation - time for practice and questions Based on real cases/ real mistakes – met immediate needs of participants Participants ‘put in situation’ – i.e. it could have been them that had made the mistake All but 4 participants indicated that all final year medical students would benefit from such a course Impact evaluation - ongoing Team Health Right Start Program Showcase 27 February 2012
7Conclusions & Lessons Learned PSPI program fills the gap in transition from student to practitioner Maintain clinical focus on avoiding adverse events: Retain the most effective and efficient learning methods Integrate communication skills development into clinical case scenarios rather than a separate session Provide opportunities for individual feedback on performance Clinician teachers are prepared and include Clinician educators with recent graduate experience Experienced clinicians with teaching and supervisory responsibilities Team Health Right Start Program Showcase 27 February 2012
8Where to from here? Finalise the PSPI Curriculum Guide incorporating: Principles and background for content covered and teaching strategies adopted (i.e. how to teach) Comprehensive description of topics, resources and facilitator actions Develop the PSPI Facilitator Training Program (How to teach) Make available the PSPI program to all medical schools Continue research plan to evaluate the longer term impact of PSPI Program Opportunities for IPL?? Team Health Right Start Program Showcase 27 February 2012