A One-Day GME Quality and GME Quality & Safety Training Safety - - PowerPoint PPT Presentation

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A One-Day GME Quality and Safety Training Session for Housestaff: Is Simulation or Traditional Didactics More Effective?

Danielle Perret, MD Associate Dean, Graduate Medical Education / DIO

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GME Quality & Safety Training

• 1. Teach new residents/fellows concepts of patient safety and

quality improvement processes

• 2. Inspire housestaff engagement in quality and safety initiatives
• 3. Expand the collaboration between GME and the hospital
• 4. Emphasize the role of the interdisciplinary team in quality and

patient safety

• 5. Determine if didactic or simulation methods were significantly

different in their impact

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• 240 new residents and fellows
• 4 full days
• 7 hours of training in safety and

quality improvement

• 60 trainees per day
• Half in traditional & peer-led didactic

sessions

• Half in simulation & role-play sessions

GME Fall Training Methods

Didactics Sessions

30 Residents

Didactics Sessions

30 Residents

Simulation & Role Play

30 Residents

Simulation & Role Play

30 Residents

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GME Fall Training Methods

• Didactics
• All participants obtained a Lean Six Sigma White Belt
• Peer Lectures: 15-minute lectures by Housestaff Safety Officers on

specific hospital safety initiatives

• Faculty Lectures: 30-minutes lectures by faculty on broader topics
• Simulation
• There were 6-8 individuals and one instructor per group
• Procedure skills stations with focus on safety, occupational risk and

infection prevention

• Role Play
• There were 30 residents and three instructors per group
• Two activities with focus on recognition and speaking up
• Professionalism
• Harassment

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GME Fall Training Methods

• Self-assessment questionnaires were completed by each

trainee before and after the training using a Likert scale from 1- 5, ranging from “not at all” to “extremely”

• attitude about quality and safety efforts
• perceived knowledge of safety and quality process initiatives
• comfort level with procedures
• attitude about targeted interpersonal interactions
• 13 question pre- and post-test was added to evaluate

knowledge before and after the sessions (2/4 sessions)

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Didactics

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Role-Playing and Simulation

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Simulation Area

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Arterial Line Station

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Role Play Station

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Participants

20 40 60 80 100 120 140 160 PGY1 PGY2 PGY3 PGY4+ Fellow

136 29 4 2 54

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Results: Self-Assessment Questionnaires

• Self-assessment questionnaires were completed by each

trainee before and after the training

• 100% response rate
• Didactics
• Residents’ and fellows’ self- assessment scores (“rate your knowledge
• r skill set”) improved in every didactics category from Pre-Training to

Post- Training

• Simulation
• The residents’ and fellows’ self-assessment scores (“rate your comfort

level at doing procedures”) improved in every simulation category from Pre-Training to Post-Training

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Didactic Presentations: Self-Assessment Scores

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Simulation: Self-Assessment Scores

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Results: Medical Knowledge Scores

• Medical Knowledge
• significant improvement
• verall change in scores from the pre- to the post-test
• 90 +/- 27 to 97 +/- 24
• p = 0.024
• 20.00%

0.00% 20.00% 40.00% 60.00% 80.00% 100.00% 120.00% Q.1 Q.2 Q.3 Q.4 Q.5 Q.6 Q.7 Q.8 Q.9 Q.10 Q.11 Q.12 Q.13 PRE POST % change

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Conclusion

• In comparing the efficacy of simulation vs. didactic teaching, both were

evidently effective (averaging greater than 20% improvement) in increasing knowledge, but there was no discernible significant difference between the two methods' efficacy

• A multidisciplinary team of physicians, nurses, administrators, GME and

medical school leaders developed and delivered a new curriculum concerning quality and safety as well as process improvement topics, provided to new housestaff as both didactic and simulation-based teaching. Simulation and didactics were equally effective teaching strategies. Trainees portrayed improved understanding of all topics over the course of the day. These sessions resulted in excellent short-term outcomes of success as measured by pre- and post-testing of housestaff self-assessments and medical knowledge