Integrating awareness of the role of human factors in medical errors into a curriculum for foundation doctors: learning from clinical incidents

Authors

  • Jivendra Gosai, Dr. Hull and East Yorkshire Hospitals NHS Trust
  • Sega Pathmanathan, Dr. Hull and East Yorkshire Hospitals NHS Trust
  • Faiza Chowdhury, Dr. Hull and East Yorkshire Hospitals NHS Trust
  • Rebekah Molyneux, Dr. Hull and East Yorkshire Hospitals NHS Trust
  • Imran Aslam, Dr. Hull and East Yorkshire Hospitals NHS Trust
  • Makani Purva, Dr. Hull and East Yorkshire Hospitals NHS Trust

Abstract

Problem
A considerable number of hospital inpatients will experience harm as a result of clinical error. Whilst there is a comprehensive investigation and reporting process when errors do occur, we are not maximising the opportunities to learn from these and reduce the risk of patients coming to harm in future.
Intervention
To address this, a course was designed and implemented to deliver human factors training using a combination of simulation methods to all  foundation doctors across a large region of the UK. This was done following a review of significant untoward incidents occurring in a 12 month period at a large teaching hospital trust. The human factors contribution to the incidents was examined and the course content designed around this.
Context
This course has been delivered to all Foundation Year One (postgraduate year one) doctors across the East Yorkshire region in the United Kingdom for two consecutive years.
Outcome
Pre- and post-course confidence was recorded and the cognitive performance of trainees analysed at two time points. Attendance at the course resulted in a significant increase in confidence levels, and a significant degradation in cognitive performance between two time points was demonstrated.
Lessons learned
It is feasible and acceptable to teach human factors to a large number of foundation trainees using this format, utilising the lessons learnt from real clinical incident reports. This results in an increase in confidence when recognising the role that human factors play in medical practice.

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Published

2015-10-01

Issue

Section

Articles