Monday, September 17, 2012

Dear HMS, Here's what it could look like.

The first known longitudinal patient safety curriculum that I know of was instituted at the University of Illinois College of Medicine.  This was rigorous and thoughtful approach to patient safety, integrated into the undergraduate medical education program.  A capstone was a four-week elective that, as David Mayer notes, became increasingly popular as time passed.

Dave recently published two blog posts summarizing this course, here and here.  Here's the part I like best:

Students were asked to address 1-3 specific research questions around each patient safety topic, and to share 2-3 relevant articles from a literature search that addressed the questions posed. Responses to each question (no less than 400 words) were then posted on the course blackboard site so others could then read and respond to their peers’ conclusions as appropriate. Answers to the questions were required to demonstrate critical thinking and scholarly investigation, and to be taken from peer-reviewed literature and referenced appropriately. The interactive, adult-learning format allowed for discourse via the blackboard around the posted answers. The course provided a forum for each student to gain substantial knowledge in patient safety, as well as prepare students for the responsibilities of residency.

These were no easy questions.  Look at these, for example:
  1. What are the key risk management concepts non-medical industries use to manage their high-risk operations?
  2. What is a safety culture and how can it help enable creating reliable and patient centered care?
  3. What can we learn from HRO research that can help inform patient safety practices in healthcare?
The course also contained several opportunities for personal reflection, again shared with other classmates. Adding this humanistic tilt to the course presents a great opportunity to break down the interpersonal barriers so often found in medical school and later in the practice of medicine.  Here is the summary:

Individual student reflection were assigned for Day 5 of each week, and designed for students to reflect on the week’s discovery and learning. Reflections were due on Saturday, and students were instructed to post comments and reactions to one another’s posts. The reflections addressed the following questions:
  1. How would you apply what you have learned this week to your professional life?
  2. What are the concepts that made you think differently than before and why?
  3. What’s your greatest “take away” learning from this week? Why?
  4. What unanswered questions remain?
  5. Any additional comments and thoughts?


Anonymous said...

Trust me, it's not that HMS lacks the ability to make a syllabus. The HMS curriculum is organized to show off the HMS academic departments. Regardless of how important it is for medical students to learn, quality improvement won't be taught thoroughly at HMS until the field grows and becomes more integrated into academic research.

Anonymous said...

Umm, anon, what is preventing HMS 'scientists' from integrating this field into their academic research themselves? No one can argue that it is not deserving of research in its own right, nor can one argue that there is not a dearth of studies - the field is crying out for more research. Could it be that the real reason is that this field is regarded as 'not academic enough'?? The prestige not big enough?

Just ask Peter Pronovost - he is leaving you all in the dust on the research question.

nonlocal MD

Jim O'Brien said...

medical schools rely on research for funding, thus, sadly, many schools lack quality/safety courses

Anonymous said...

I was the first anonymous poster. To the nonlocal MD, I agree with everything you said. I wasn't trying to imply otherwise.

I think you hit the nail on the head that the field is not perceived as prestigious or academic enough at the moment.