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Content ArticleJunior doctors can struggle with decision-making in emergency departments because they worry about “looking silly” in front of senior colleagues, a study has found. A team from the Healthcare Safety Investigation Branch (HSIB) looked at missed or delayed diagnosis of conditions in A&E. They specifically examined cases of pulmonary embolism and focused on diagnostic decision-making using applied cognitive task analysis. Interviews with medical staff found a number of factors which were common among expert level doctors. These included being aware of life-threatening conditions and seeking to rule them out, being comfortable in expressing doubt and seeking out peers to challenge their diagnosis. Junior staff on the other hand often tried to fit symptoms to specific conditions and had a fear of making wrong a diagnosis. Some said they were afraid of “looking silly in front of a senior”. The study, presented at an online session at the Ergonomics & Human Factors 2022 conference, suggested looking at how younger staff can be supported in improving their decision-making. HSIB investigator Nick Woodier, who presented the study, said: “Decision-making is a skill, commonly developed in healthcare through experience without formal training or opportunities to practise it.” You can view the presentation from the link below.
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Content Article
BMA: Racism in medicine (15 June 2022)
Patient Safety Learning posted an article in Culture
This report presents the findings of the British Medical Association (BMA) racism in medicine survey, which ran from October to December 2021. The survey sought to gather evidence of the racism experienced by doctors and medical students working in the NHS, and the impact of these experiences on their working lives and their career opportunities. All doctors and medical students in the UK, from all ethnic backgrounds, were invited to participate. The survey received 2030 responses in total, making it one of the largest of its kind. It found a concerning level of racism in the medical profession, stemming from fellow doctors, other NHS staff, and patients. These experiences of racism present in a variety of forms in the institutions and structures of the medical profession- Posted
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News Article
Trainee doctors in ‘meltdown’ at major hospital maternity department
Patient Safety Learning posted a news article in News
Regulators have raised serious concerns over trainee doctors within the maternity department at one of the largest trusts in the country. The NHS’ training regulator said it had concerns over the treatment of trainee doctors within the obstetric and gynaecology department at University Hospitals Birmingham Foundation Trust, while some medics report being in ‘meltdown’. Reviewers raised an incident where a consultant had refused to respond to an obstetric emergency in A&E which had been requested by a junior doctor. “The panel unanimously agreed that Consultant presence was required without delay,” the report added. The latest review follows concerns in November 2020 and June 2021 when patient safety issues were also identified. It warned there was a “real risk” trainees would soon become “hesitant and reluctant” to call for consultant support when need. Read full story Source: The Independent, 5 June 2022 -
News Article
791 medical graduates could miss out on NHS junior doctor training
Patient Safety Learning posted a news article in News
The highest ever number of medical students have been told there are no places for them this year, despite the health service’s crippling shortage of medics. The risk that young would-be doctors may not be allocated to start their training at a hospital in the UK has sparked concern among the medical students affected, as well as medical organisations. Pressure is growing for action to close the gap between the number of training places available across the NHS and the number of graduates seeking one, so medical talent is not wasted and hospitals hire as many fresh recruits as they can to help tackle the widespread lack of medics. Doctors are worried that the mismatch between demand for and supply of training places will lead to the NHS missing out on medics it sorely needs and that some of those denied a place will either go to work abroad instead or give up medicine altogether. The most recent official figures showed that the NHS in England is short of almost 8,200 doctors. Dr Dustyn Saint, a GP in Norfolk, tweeted the health secretary, Sajid Javid, about the situation, saying: “Sajid Javid sort this out! You know how much general practice needs these people in a few years, standing by and doing nothing is inexcusable.” Another doctor said: “It’s bonkers that 800 would-be doctors could be denied training places at a time when the NHS in England is short of 8,200 doctors.” The British Medical Association has voiced concern about the large number of unallocated medics. “Now we have a situation where a record number are left with unnecessary uncertainty about where they are headed this August,” said Khadija Meghrawi, the co-chair of its medical students committee. “In a time where student mental health is declining, this additional source of uncertainty and stress is particularly unfair.” Read full story Source: The Guardian, 15 March 2022 -
Content ArticleTraining was recognised as a “bridge to quality” 20 years ago and quality improvement is now integrated into appraisal for doctors in training and outcomes for undergraduate medical education. In the UK, expectations for training of doctors in their first two years after graduation are set by the UK Foundation Year curriculum, which states that FY2 doctors are required to contribute significantly to at least one quality improvement project and report their work in their e-portfolio. Two systematic reviews found that teaching quality improvement and patient safety to trainees frequently resulted in changes in clinical processes. However, there are concerns that trainees in the UK are on short rotations, have limited time or support, and may perceive that they lack authority to persuade colleagues that problems need tackling. This article describes an approach which applies evidence about successful quality improvement training to a curriculum on healthcare improvement for doctors in their first two years of training, drawing on the authors’ experiences. The article recommends principles to help integrate quality improvement into medical training.
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News Article
Eating disorders: Worth more than 2 hours of teaching
Patient Safety Learning posted a news article in News
On average, UK medical students receive less than two hours of teaching on eating disorders throughout their entire medical degree. Even more concerningly, a fifth of medical schools do not include eating disorders at all in their teaching. Given that 1 in 50 people in the UK suffer from an eating disorder, and around 5% of the population will be affected at some point in their lifetime, this is something that needs to change. This week is Eating Disorders Awareness Week and Beat Eating Disorders are campaigning for UK medical schools to introduce comprehensive training on eating disorders to their programmes. Eating disorders are highly complex mental illnesses, but they are treatable. Just two hours of training is not enough time to equip medical students with the knowledge to identify the signs and symptoms and provide the necessary support to help sufferers access the most appropriate treatment at the earliest opportunity. Read more Source: Beat Eating Disorders -
Content Article
TAKE STOCK – Hot debrief tool (29 October 2019)
Patient-Safety-Learning posted an article in Emergency medicine
Debriefing after a patient death or serious incident is important for staff wellbeing, especially in the emergency medicine environment. While on placement in an emergency department, medical student Max Sugarman realised there was no debrief for staff or students involved in critical incidents. This led him to develop the TAKE STOCK hot debrief tool, which is an adaption of the STOP5 model created by Edinburgh EM and the Scottish Centre for Simulation and Clinical Human Factors. In this blog, Max talks about how critical incidents affect staff, how to make time for debriefs and how the TAKE STOCK tool works in practice. -
News ArticleMedical students aided by an AI tutor outperformed peers taught remotely by human experts in a complicated surgical training procedure, new research reports. The Neurosurgical Simulation and Artificial Intelligence Learning Centre in Montreal, Canada, randomly assigned 70 students feedback and assistance from either a sophisticated AI system, a remote expert human instructor, or neither, while they removed virtual brain tumours using a neurosurgical simulator. The AI system, called the Virtual Operative Assistant (VOA), delivered personalised feedback to its students via a machine learning algorithm to teach them safe surgical techniques. Human instructors observed the students over a live feed and gave instructions based on their performance. The students tutored by the AI system learned surgical skills 2.6 times faster and performed 36 per cent better than those advised by human experts, without experiencing the heightened stress the researchers had anticipated. Using AI training models to tutor students could be an effective way to improve their skills and patient safety while reducing the burdens placed on human instructors, the study, published in the Journal of the American Medical Association, found. “Artificially intelligent tutors like the VOA may become a valuable tool in the training of the next generation of neurosurgeons,” said Dr Rolando Del Maestro, the study’s senior author. Read full story Source: iNews, 22 February 2022
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News Article
HEE tells trusts to prioritise training, or services will suffer
Patient Safety Learning posted a news article in News
The quality and performance of services will suffer if medical training is not ‘prioritised and funded’ by trusts, Health Education England (HEE) has warned. HEE has set out actions in its “Covid training recovery interim report” that must be done alongside NHS England, the Department of Health and Social Care and others to protect post-covid workforce recovery. At the beginning of the pandemic, junior doctors’ training was severely disrupted because thousands of staff were redeployed to covid wards, while most routine elective operations and diagnostic procedures were stopped. HEE says training has still not returned to pre-covid levels, and fears there could be further disruptions over winter if significant volumes of elective care are cancelled. According to its report, if medical training is not “prioritised and funded”, the “long-term costs to service are significantly greater”. “If delivery recovery is prioritised over training recovery there will be an initial increase in service delivery time and value, but this will be followed swiftly by a reduction in service delivery time and value,” it warned. Read full story Source: HSJ, 13 October 2021 -
Content ArticleFollowing the major disruption to postgraduate medical education during the last year of the COVID-19 pandemic, Health Education England (HEE) has worked with NHS England & NHS Improvement, NHS Employers, the Department of Health and Social Care, the General Medical Council, the Academy of Medical Royal Colleges, and others to support training recovery as an urgent priority and mitigate the impact of the pandemic on doctors in training.
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Content Article
Imperial College London: MSc in Patient Safety
Patient Safety Learning posted an article in Medical students
A fully online Master’s in Patient Safety has been launched by Imperial College London and Bayer Pharmaceuticals. The course aims to develop global leaders and changemakers in patient safety who can catalyse improvements and innovation in healthcare practice across the globe. The programme, now open to UK and international applicants for the next academic year, is a refreshment of Imperial’s previous Patient Safety MSc offering, designed to enable a more flexible approach to learning and respond to emerging healthcare needs in light of the coronavirus pandemic. The new course aligns with the updated World Health Organization’s Patient Safety Curriculum. It features best-practice frameworks from healthcare systems around the world, as well as real-world insights and case studies from a pharmaceutical setting. The programme is delivered through a combination of online learning, group learning and live virtual teaching sessions from world-leading experts in the field. Students will also have the opportunity to apply their learnings through the completion of a research study addressing a patient safety challenge. -
News Article
Regulator removes struggling hospital’s junior doctors
Patient Safety Learning posted a news article in News
Ten junior doctors have been removed from a struggling hospital over concerns they were being left without adequate supervision on understaffed wards. Health Education England (HEE) removed the 10 foundation year one doctors, all on a general medicine rota, from Weston General Hospital last month. The General Medical Council said the trust’s previous efforts to address the issues “have not been sufficient or sustainable”. University Hospitals Bristol and Weston Foundation Trust did not say which services HEE had removed the juniors from or what mitigations had been put in place. However, the trust told HSJ none of the positions concerned were from the hospital’s emergency department, where the GMC has already imposed conditions on juniors’ training. HEE very rarely uses its power to withdraw trusts’ trainees. HSJ reported last June the regulator had only removed two posts at trusts under enhanced monitoring since the start of 2019. William Oldfield, University Hospitals Bristol and Weston FT medical director, said in a statement to HSJ: “We recognise the seriousness of the step taken by HEE to temporarily suspend the training programme for a small number of junior doctors at Weston General Hospital. ”We are working to provide the assurance HEE require to allow this training to recommence, and in the meantime we have appropriately mitigated the impact on services at Weston.” Read full story (paywalled) Source: HSJ, 10 May 2021 -
Content ArticleHealth Education England (HEE) has published a suite of resources to help support workers, employers, and integrated care systems (ICSs) prepare for the implementation of HEE’s Allied Health Profession (AHP) Support Worker Competency, Education and Career Development Framework.
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Content ArticleThis book focuses on the consumer’s perspective and emphasises how advocacy can influence change in healthcare quality at multiple social levels. This introductory volume synthesises patient advocacy from a multi-level approach and is an ideal text for graduate and professional students in schools of public health, nursing and social work.
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Content ArticleThis toolkit from the British Medical Association looks at some of the key challenges students may come across when undertaking a medical elective in a developing country. Topics covered include: Staying within your competence Emergency situations Maintaining ethical standards Minimising burdens on the host country.
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Content ArticleThis guidance from the Chartered Institute of Ergonomics and Human Factors (CIEHF) is aimed at early career pharmacists, especially those in foundation pharmacist positions managing the transition from education to the workplace environment. Support in clinical decision-making is recognised as an educational development need for early career pharmacists, making the transition from a university education where there is very little exposure to the clinical environment into the work environment. This situation is compounded by a policy landscape which puts the pharmacist in a central role for clinical management of long-term complex morbidities, making clinical decision making and taking responsibility for patient outcomes increasingly important. The guidance will also be of use to those involved in the education and mentorship of early career pharmacist.
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Content ArticleIn medical schools, students seek robust and mandatory anti-racist training. Activists especially want to see their institutions recognise their own missteps, as well as the racism that has accompanied past medical achievements. Read Elizabeth Lawrence's article in the Washington Post.
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News Article
The medical school trying to become anti-racist
Patient Safety Learning posted a news article in News
A major British medical school is leading the drive to eliminate what it calls "inherent racism" in the way doctors are trained in the UK. The University of Bristol Medical School says urgent action is needed to examine why teaching predominantly focuses on how illnesses affect white people above all other sections of the population. It comes after students pushed for reform, saying gaps in their training left them ill-prepared to treat ethnic minority patients – potentially compromising patient safety. Hundreds of other UK medical students have signed petitions demanding teaching that better reflects the diversity of the country. The Medical School Council (led by the heads of UK medical schools) and the regulator, the General Medical Council, say they are putting plans in place to improve the situation. A number of diseases manifest differently depending on skin tone, but too little attention is given to this in training, according to Dr Joseph Hartland, who is helping to lead changes at the University of Bristol Medical School. "Historically medical education was designed and written by white middle-class men, and so there is an inherent racism in medicine that means it exists to serve white patients above all others," he said . "When patients are short of breath, for example, students are often taught to look out for a constellation of signs – including a blue tinge to the lips or fingertips – to help judge how severely ill someone is, but these signs can look different on darker skin." "Essentially we are teaching students how to recognise a life-or-death clinical sign largely in white people, and not acknowledging these differences may be dangerous," said Dr Hartland. Read full story Source: BBC News, 17 August 2020 -
News Article
Patients Know Best launches education programme for medical students
Clive Flashman posted a news article in News
Patients Know Best has launched an education programme which can be used by medical schools. Among the first to use the programme are undergraduate Pharmacy students at Liverpool John Moores University (LJMU). The Patients Know Best platform, which recently became the first personal health record to be fully integrated into the NHS App, has been incorporated into the curriculum to facilitate simulated interactions between patients and pharmacists. This has involved training the students to use Patients Know Best to enable their use of the platform to interact and collaborate with each other. Read the full article here. -
News ArticleAll medical students at the National University of Singapore will be taught patient safety through a virtual reality (VR) game, a move prompted by the COVID-19 social distancing rules. The game, called PAtient Safety aS Inter-Professional Training (PASS-IT), will use VR to get all 1,500 of them acquainted with the proper procedures in operating theatres. It was developed by the NUS Yong Loo Lin School of Medicine (NUS Medicine). The school has 12 such VR stations. Each has a 15-minute game with various medical scenarios that will require the students to "act out" the standard operating procedures. These range from how to check for a patient's consent and verify their identity as well as the correct ways to handle surgical tools and what must be done if a team member accidentally cuts himself. "This VR system is a good tool to help the students consolidate their learning despite increased clinical restrictions," said Associate Professor Alfred Kow, assistant dean of education of NUS Medicine. Read full story Source: The Straits Times, 5 August 2020
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Content ArticleSLIPPS (Shared LearnIng from Practice to improve Patient Safety) is a 3 year Erasmus+ funded Patient Safety education project. The project will: draw on the real experiences of health/social care students in practice placements utilise these experiences as the basis for a range of educational resources set up an international patient safety education network build an international open access virtual learning centre for international, multi-professional learning about patient safety Who is involved? 7 Higher Education institutions 5 Health and/or social care providers 5 European countries (UK, Finland, Spain, Italy and Norway)
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News Article
Global accolades for patient safety research
Patient Safety Learning posted a news article in News
Research into patient safety across Europe, led by Northumbria University, has received international acclaim. The SLIPPS (Shared Learning from Practice to improve Patient Safety) project is a major EU-funded project led by Professor Alison Steven, a Reader in Health Professions Education at Northumbria University. It seeks to improve European patient safety and education across a range of clinical settings. Errors, mishaps and misunderstandings are common and around one in 10 patients suffer avoidable harm. These incidents impact upon patients, their families, health care organisations, staff and students. SLIPPS is responding to the challenge to improve patient safety education. Professor Steven has a longstanding interest in the use of education to raise standards of care and ensure patient safety. Considering the rapid spread of COVID-19, she says improving patient safety and standards of care across Europe and beyond, has never been more important. “Patient safety is paramount in these extreme circumstances,” said Professor Steven. “The SLIPPS project is unique in that it taps into students’ experiences. These students on practice placements have the potential to offer fresh perspectives on clinical practices, and with so many final-year students treating patients on the front line during this global pandemic, their current views on patient safety are more important than ever.” The project utilises real-life experiences and students’ reflections on them as the basis for a range of educational resources which feed into an open access virtual learning centre for international, multi-professional learning about patient safety. Read full story Source: Northumbria University Newcastle, 20 July 2020 -
Content ArticleDr Susan Whalley-Lloyd, Senior Lecturer in Human Factors/Ergonomics at Staffordshire University, explains in this short video presentation why a human factors course is important for patient safety and what the course at Staffordshire University covers.
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Content ArticleA medical student describes his experiences of working in the ICU of his local hospital during coronavirus in this Independent blog. "I was one of the first medical students at my university to be recruited to help out in local hospitals as fears grew about the NHS being overwhelmed by COVID-19."
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Content ArticleNHS Education for Scotland has developed a TURAS Learn page to support student pharmacists in Scotland.
