Skill acquisition
Quality Improvement and Patient Safety (QIPS) is a recognized competency across residency programs. Although a variety of teaching modalities exist, many do not represent the multifaceted clinical environment that trainees work in. Residents have reported challenges in linking QIPS classroom-based learning with their clinical duties. High-fidelity simulation has been used to bridge this gap within clinical skills teaching and therefore has the potential to address this issue in QIPS learning.
Approach: We developed and piloted four high-fidelity simulation scenarios with 15 surgical residents (Orthopaedics, General Surgery, Gynaecology and Neurosurgery). Each scenario contained elements of both latent and active safety errors. Residents were provided with a short pre-reading from an open-access resource on basic QIPS methodology and underwent a debriefing by a trained QIPS faculty. Residents were then tasked to apply their learning to their scenario to develop a QIPS-focused solution.
Evaluation: Objective knowledge acquisition was assessed with the Quality Improvement Knowledge Assessment Tool-Revised (QIKAT-R) in conjunction with a survey based upon the Kirkpatrick Model of Learning. Overall, residents agreed that the simulation helped them learn QIPS methodology and agreed that they could perform fundamental QIPS tasks. The average QIKAT-R score demonstrated a trend toward improvement.
Implications: High-fidelity simulation is a potential means to provide residents with hands-on experience in QIPS knowledge acquisition and application. Future directions should aim to compare the efficacy of simulation with other teaching modalities and evaluate the long-term impact of QIPS teaching on resident behaviors and motivation to take part in QIPS initiatives 1)