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IHI poster

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IHI poster

  1. 1. One of the learning objectives / instructional goals of the Ethics and Professionalism elective course on “Patient Safety: Better Knowledge for Safer Care” introduced to Kuwait University since 2005 was to “Enable students to make judgments about the safety of clinical practice through the use of reflective thinking & writing tools to enhance their moral development as future doctors” achieving a higher category of learning based on the Cognitive Domains of Learning (Blooms’ Taxonomy, Fig 1). INTRODUCTION: Patient Safety Education For Future Doctors: A Reflective Strategy Eating Unsafe Culture Slowly and Surely Manal Bouhaimed,[1,2] Hossam Elamir[3] [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 Fig 1: Bloom’s Taxonomy (Revised) Remembering Understanding Applying Analyzing Evaluating Creating 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 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 DO IT. What? What happened? What were the results? Now What? What will I do differently next time? So What? What do these results imply? How did I influence the outcome? Description What happened? Description What sense can you make of the situation? Fig 2: Gibbs Reflective Cycle Feelings What were you thinking and feeling? Action Plan If it arose again, what would you do? Conclusion What else could you have done? Evaluation What was good & bad about the experience? Concrete Experience (Feeling) Fig 3: 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) A one day informed consent and surgical check lists audit at a secondary care hospital in Kuwait Students' Reflection on Current Practice to Avoid Tubing Misconnection: A Simple Solution, A Difficult Compliance, A Training Opportunity Is The Accreditation Program Enough To Ensure Patient Safety? A Students' Reflection On A Patient Safety Required Area Exploring students' Feelings Counts in Education: The Use of Gibbs Reflective Cycle in Teaching Clinical Ethics Inpatient Wards TPN Unit Laboratory Treatment Rooms Pharmacy Medical Records Operating Theatre The following reflective tools were used in an academic context for teaching this elective course: • Gibbs Reflective Cycle (Fig 2). • The Kolb’s cycle (Fig 3). • The Burton’s approach (Fig 4). The use of these tools in a hospital based rotations (Fig 5a) aimed at: Looking back at an event or having a hands-on experience. Analyzing the event, ideas or emotions/responses related to the event (thinking in depth and from different perspectives, trying to explain what happened, for example with reference to the WHO Nine Patient Safety Solution (Fig 5b). Thinking carefully about what the event or idea means for them and their on-going development as future care providers and practicing professionals. METHODS: The outcomes of these reflective exercises over the years were presented at different conferences and meetings (Fig 5c). The following are some examples: • The Gibbs Reflective Cycle was applied to the students’ experience of reviewing 33 unidentifiable medical records for the application of “Performance of Correct Procedure at Correct Body Site” protocol in the hospital. • The Kolb’s cycle was applied to the students’ experience of examining 152 patients for hospital adherence to the “Avoiding Catheter and Tubing Misconnections” protocol. • The Burton’s approach of reflection was used during the assessment of 41masked non-identifiable consent forms to assess to the pre-intervention patient’s verification protocol. Results: It was evident that the students in this elective course successfully developed a new realization of the role of human factors in errors and the concept of system failure suggesting that reflective education for patient safety can be successfully used in patient safety education. Conclusion: What is most important, interesting, useful, relevant about the object event or idea? Interpretation: What happened? Description: What have I learned from this? What does this mean for my future? Outcome: Acknowledgement: We would like to acknowledge the assistance provided by Dr. Susan Jacob; Department of Community Medicine and Behavioural Sciences, and Quality Nurses of Mubarak Al-Kabeer Hospital: Abeer G. Dossokey, Amal T. Mohamed, Asila A. Alrasheedi, Lea Martinez & Rinto Francis. Fig 4: The Burton’s approach Fig 5a: The Hospital Based Rotations Patient safety Solutions Look-alike,Sound-Alike (LASA) Medication Names Patient Identification Single Use of Injection Devices Performance of Correct Procedure at Correct Body Site Improved Hand Hygiene to Prevent Healthcare-Associated Infection Assuring Medication Accuracy at Transitions in Care Avoiding Catheter and Tubing Misconnection Control of concentrated electrolyte solutions Communication During Patient Handovers Fig 5b: Fig 5c: Poster Abstracts

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