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  1. 1. Students' Reflection on Current Practice to Avoid Tubing Misconnection: A Simple Solution, A Difficult Compliance, A Training Opportunity AlRasheedi S [1] , Borahmah A [1] , Al-Braheem A [1] , Elamir H [3] , Jacob S [1] , Bouhaimed M [1,2] [1] Department of Community Medicine and Behavioural Sciences, Kuwait University Faculty of Medicine. [2] Department of Surgery, Kuwait University Faculty of Medicine. [3] Department of Quality and Accreditation, Mubarak Al-Kabeer Hospital, MOH Case Summary:Background: Learning consists of cognitive, emotional and social dimensions. In medical education, the cognitive dimension is usually measured through assessments of performance (Fig 1), while the social and emotional dimensions are more challenging to capture. One of the objectives of the course on “Patient Safety: Better Knowledge for Safer Care” is to support emotional reflection in the learning process to enable a critical assessment of both self as a professional –in our case a future doctor- and as an agent of change. The Kolb’s cycle (Fig 2) begins with a concrete experience or task, reflecting on the experience and then applying the learning to new situations. In this case report, we present the task of carrying out a patient safety hospital round as an object of reflection to explore adherence to the “Avoiding Catheter and Tubing Misconnections” protocol which is one of the World Health Organization (WHO) “Nine Patient Safety Solutions” adopted by the Ministry of Health in Kuwait. Harming patients can take place at different levels within health care like lack of funding, system level (structure or process), or at the point of interaction between patients and practitioners. When asked to reflect about their experience, it was evident that the students in this elective course successfully developed a new realisation of the role of human factors in errors and the concept of system failure suggesting that training for patient safety should start early during medical education. Conclusion: We would like to acknowledge the assistance provided by Quality Nurses of Mubarak Al-Kabeer Hospital: Abeer G. Dossokey, Amal T. Mohamed, Asila A. Alrasheedi, Lea Martinez & Rinto Francis. Acknowledgement: Contacts: The students completed a hospital round of 19 wards and inspected 175 opportunities in tubing of 152 patients who had different catheters and tubes for the following criteria: Nursing Notes Labelling of Proximal and Distal ends Full 53.1% Partial 8.6% Not 38.3% Full 55.4% Partial 1.7% Not 42.9% Rooting Tubes and Catheters in correct directions Yes 99.4% No 0.6% Name or Number and Date of insertion Yes 85.1% No 14.9% Documentation of Tubes and Catheter in nursing notes at the start of the shift Concrete Experience (Feeling) Fig 2: Kolb’s Learning Cycle Abstract Conceptualisation (Thinking) Adapted by Ivan Mactaggart from Mcleod,2010 “Learning is the process whereby knowledge is created through the transformation of experience” (David A Kolb, 1984) http://www.simplypsychology.org/learning-kolb.html #sthash.DOwEfaZC.q20UZ5MW.dpbs Reflective Observation (Watching) Active Experimentation (Doing) Remembering Understanding Applying Analyzing Evaluating Creating 1. Bloom, Benjamin (ed.). Taxonomy of Education al Objectives. Handbook I: Cognitive Domain. David McKay Company, Inc. New York: 1956. http://pcs2ndgrade.pbworks.com/w/page/46897760/Revised%20Bloom's%20Taxonomy Fig 1: Bloom’s Taxonomy (Revised) Can the student distinguish between different parts? Appraise, compare, contrast, criticize, differentiate, discriminate, distinguish, examine, experiment, question, test Define, duplicate, list, memorize, recall, repeat, state Can the student recall or remember the information? Can the student explain ideas or concepts? Can the student use information in a new way? Classify, describe, discuss, explain, identify, locate, recognize, report, select, translate, paraphrase Choose, demonstrate, dramatize, employ, illustrate, interpret, operate, schedule, sketch, solve, use, write Can the student justify a stand or decision? Appraise, argue, defend, select, support, value, evaluate Can the student create a new product or point of view? Assemble, construct, create, design, develop, formulate, write For further information, please contact Dr. Manal Bouhaimed Email: manal_q8 @hsc.edu.kw - Tel (office): 24636532

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