Presenter: Alan Rubin, MD
Institution: University Of Vermont College of Medicine, Fletcher Allen Health Care, Division of General Internal Medicine
Other Authors: Benjamin Littenberg MD, Anupam Goel MD, Charles MacLean MD, Dana Walrath PhD, Dryver Houston PhD, Tania Bertsch MD, Paul Turner PhD, Tracey Niquette RN, ANP
Introduction: Medical Errors are common, and all of us are touched their effects: our patients by increased morbidity and mortality; society by increased costs; and ourselves by blame and shame. In order to introduce Medical Errors into our new curriculum, we developed a module for our clinical bridge. The module encompasses the concept and language of error, encourages sharing of personal experience with medical error, demonstrates a chain of errors, and allows participants to practice error analysis using the techniques of Root Cause Analysis.
Methods: The module was developed for clinical clerks at the University of Vermont College of Medicine and presented to a group of 60 during a bridge week of their clerkship year. We used large and small groups to improve knowledge, attitudes and skills around error.
A Curriculum for Medical Errors
- Large Group-View presentation, "The Concept and Language of Error.".
- Large Group-Discuss personal experience with error.
- Large Group- View videotape, "First Do No Harm," and identify and tabulate errors to review.
- Large Group-View presentation, "Techniques of Error Analysis."
- Small Groups- Analyze an error seen on the videotape.
- Large Group- Review analyses and summarize session.
Results: This module has been presented to 2 consecutive classes at the UVM College of Medicine, and to participants at a Pre-Course Session of the Society of General Internal Medicine. Evaluations of the student session were done using a 7 question pre-post questionnaire, and a more qualitative evaluation as part of the Bridge evaluation process. There was little change in the students’ knowledge and attitudes about error as judged by our questionnaire, but most students found the module interesting, thought provoking, and would like these discussions to continue.
Discussion: We developed a module for our new curriculum about the language and culture of error. We learned that by the time students are in the middle of their clerkship year, they have witnessed errors and are thinking actively about them. Even though our questionnaire did not demonstrate improvement in knowledge or attitudes, our students thought the topic was thought provoking, important, and worth continuing as part of their learning.
A copy of our Powerpoint presentation, and information about the video are available by writing to Dr. Rubin at alan.rubin@uvm.edu.
Discussion: We developed a module for our new curriculum about the language and culture of error. We learned that by the time students are in the middle of their clerkship year, they have witnessed errors and are thinking actively about them. Even though our questionnaire did not demonstrate improvement in knowledge or attitudes, our students thought the topic was thought provoking, important, and worth continuing as part of their learning.
A copy of our Powerpoint presentation, and information about the video are available by writing to Dr. Rubin at alan.rubin@uvm.edu.
