Patients and families as teachers: a mixed methods assessment of a collaborative learning model for medical error disclosure and prevention
Patients and families as teachers: a mixed methods assessment of a collaborative learning model for medical error disclosure and prevention
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DOI：
10.1136/bmjqs-2015-004292
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发表时间：
2016-08-01
影响因子：
5.4
通讯作者：
Bell, Sigall K.
中科院分区：
文献类型：
--
作者：
Langer, Thorsten;Martinez, William;Bell, Sigall K.
背景尽管越来越多的患者和家属（P/F）参与患者安全教育的兴趣，很少有人知道P/F如何才能最好地作出贡献。我们评估的可行性和可接受性的病人-教师的医疗错误披露和预防training model.Methods我们开发了一个教育干预，使跨专业的临床医生与P/F从医院咨询委员会讨论错误披露和预防。病人焦点小组和指导会议通知课程和评估设计。使用定性和定量问题的前后调查来评估P/F和临床医生对协作安全教育的经验和态度，包括参与者的希望，恐惧，学习经验和挑战的感知价值。根据内容分析的原则对开放式问题的回答进行编码。结果P/F和临床医生希望了解对方的观点，沟通技巧和患者赋权策略。在干预之前，两组人都担心权力动态会阻碍有效的互动。临床医生担心P/F会了解他们的易错性，而P/F则担心临床医生的行话和防御姿态。研讨会后，临床医生重视病人的直接反馈，沟通策略的错误披露和“真实的”学习经验。P/F赞赏临床医生的问责制，以及对医疗差错如何影响临床医生的见解。一半的参与者认为没有什么挑战性，其余的临床医生引用了情感和“文化变革”的真实性，而P/F则评论了医学术语和更多时间的愿望。患者和临床医生认为这些经验很有价值。关于如何开发一个病人教师计划在病人safety.Conclusions的教育范式，包括病人作为教师和合作学习者与临床医生在病人safety. Conclusions是可行的，重视临床医生和P/F和有前途的P/F为中心的医疗差错披露和预防培训。
Background Despite growing interest in engaging patients and families (P/F) in patient safety education, little is known about how P/F can best contribute. We assessed the feasibility and acceptability of a patient-teacher medical error disclosure and prevention training model.Methods We developed an educational intervention bringing together interprofessional clinicians with P/F from hospital advisory councils to discuss error disclosure and prevention. Patient focus groups and orientation sessions informed curriculum and assessment design. A pre-post survey with qualitative and quantitative questions was used to assess P/F and clinician experiences and attitudes about collaborative safety education including participant hopes, fears, perceived value of learning experience and challenges. Responses to open-ended questions were coded according to principles of content analysis.Results P/F and clinicians hoped to learn about each other's perspectives, communication skills and patient empowerment strategies. Before the intervention, both groups worried about power dynamics dampening effective interaction. Clinicians worried that P/F would learn about their fallibility, while P/F were concerned about clinicians' jargon and defensive posturing. Following workshops, clinicians valued patients' direct feedback, communication strategies for error disclosure and a 'real' learning experience. P/F appreciated clinicians' accountability, and insights into how medical errors affect clinicians. Half of participants found nothing challenging, the remainder clinicians cited emotions and enormity of ` culture change', while P/F commented on medical jargon and desire for more time. Patients and clinicians found the experience valuable. Recommendations about how to develop a patient-teacher programme in patient safety are provided.Conclusions An educational paradigm that includes patients as teachers and collaborative learners with clinicians in patient safety is feasible, valued by clinicians and P/F and promising for P/F-centred medical error disclosure and prevention training.