Beverley Bird (Monash University); Tangerine Holt (Monash University); Brian Jolly (Monash University)

Background

Patient safety is addressed nationally through organizations such as the Canadian Patient Safety Institute, the UK NHS National Patient Safety Agency and the National Patient Safety Education Framework (Australia) and others. However, there is little practical guidance about how assessment and awareness of patient safety can be raised at the individual practitioner level.

Purpose

To develop, apply and validate a Patient Safety MiniCEX (PSM) as an integrated patient safety education and formative assessment package for international medical graduates, residents and medical students in workplace (clinical) settings.

Methods

The development, testing, refining and validation of the PSM Categories and Items and Competency Indicators proceeded through seven stages over two years. A Patient Safety Education Model was established from a comprehensive review of international literature. Ethics approval was gained for the testing of the PSM of four categories with 18 Knowledge Items and 128 Competency Standards ranked for their Importance and Relevance by trainees, clinicians and the engagement of key stakeholders via a ‘Think Tank’. The PSM was tested and modified through testing in OSCE, High and Low Fidelity Simulation encounters, and clinical (general hospital) settings, including statistical analyses of item performance. Reliability was achieved through standardization of clinical scenarios and assessor and facilitator training.

Results

There were 150 participants recruited. Data was analyzed from 2 eight-stations OSCE rotations, 4 four-scenario simulation encounters and 60 patient encounters in clinical settings. Reliability modeling of OSCE and Simulation items reduced the Knowledge Items needed for reliability from 18 to 13. Three rounds of expert clinician consultation reduced the accompanying Competency Standards from 129 to 38.

Areas where participants consistently performed at an unsatisfactory or borderline satisfactory standard were Managing Information, Clinical Judgment and Decision Making, Communication and Infection Control. Qualitative data from supervisors validated these findings.

Applications

The PSM package promises to be an important and innovative educational tool which leads to safer practice.

Future Directions

The potential exists for innovative international collaboration.

Declaration

The authors have no acutal or potential conflict of interest to disclose in relatin to this presentation