Volume 197 - Issue 6
Simulation in clinical teaching and learning
Authors: Susan A Welch, Julie L Gawthorne and Melinda J Berry
Med J Aust 2012; 197 (6): 331-332. || doi: 10.5694/mja12.11015
Published online: 17 September 2012
Published online: 17 September 2012
To the Editor: In their article, Weller and colleagues describe how simulation can be used to reduce the underlying causes of adverse events.1 They point out that the Lucian Leape Institute is urging medical schools to take advantage of simulation to equip students with skills to protect patient safety.2 We are encouraged by this, and wish to share our experience of using simulation to improve ...
To the Editor: In their article, Weller and colleagues describe how simulation can be used to reduce the underlying causes of adverse events.1 They point out that the Lucian Leape Institute is urging medical schools to take advantage of simulation to equip students with skills to protect patient safety.2 We are encouraged by this, and wish to share our experience of using simulation to improve patient safety, specifically to reduce medication incidents.
Our Medication Incident Review Committee (MIRC) recognises that many incidents recur, and staff may not learn from medication incidents, or realise their significance, unless they are actually involved in an incident and its consequences. The Patient Safety Simulation Centre faculty participates in MIRC meetings, and translates de-identified incidents reported to the MIRC into learning objectives, presented in the form of simulated scenarios. These are used in our simulation centre for teaching medical officers and nurses.
For example, one scenario involved a drug being prescribed by trade name rather than generic name. This has the potential for a patient’s allergy to this drug not to be recognised before drug administration and for the patient to develop anaphylaxis.
The scenario allows for no-blame discussion of medication checking procedures, generic prescribing, patient identification, and anaphylaxis recognition and management.
Subsequent patient safety learning objectives have focused on communication regarding admission treatment decisions, effects of interruptions on occurrence of errors3,4 and monitoring response to medications (eg, insulin infusions).
Our goal is to share with all staff what we have learnt from reported medication incidents. We find simulation to be a powerful way of doing this.
Competing interests
No relevant disclosures.
References
- Weller JM, Nestel D, Marshall SD, et al. Simulation in clinical teaching and learning. Med J Aust 2012; 196: 594. 0_CHDFAHIG
- Lucian Leape Institute. Unmet needs: teaching physicians to provide safe patient care. Boston: National Patient Safety Foundation, 2010. http://www.npsf.org/wp-content/uploads/2011/10/LLI-Unmet-Needs-Report.pdf (accessed Apr 2012).
- Westbrook JI, Woods A, Rob MI, et al. Association of interruptions with an increased risk and severity of medication administration errors. Arch Intern Med 2010; 170: 683-690. 0_pgfId-2645529
- Nimmo G, Mitchell C. A preliminary audit of interruptions in intensive care: implications for patient safety. JICS 2008; 9: 240-242. http://journal.ics.ac.uk/pdf/0903240.pdf (accessed Aug 2012).