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

Patient Safety Profiling Tool

Development and Testing of the Patient Safety Profiling Tool and Competency Standards with MiniCEX Component (Patient Safety MiniCEX — PSM): Raising IMGs, Residents and Medical Students awareness of patient safety standards in OSCE, Simulation and Clinical Settings

Background Statement

Capacity to practise safely is a complex attribute that is difficult to assess. The Patient Safety MiniCEX Tool was developed as a formative assessment to rate patient safety in practice at an individual practitioner level during clinical encounters. This study, funded by the Department of Health Victoria, initially targeted International Medical Graduates (IMGs) in acute hospitals. Faculty and supervisors of Residents and Medical Students have since adopted the Patient Safety MiniCEX for use with these groups.

Purpose

To develop, apply and validate a Patient Safety MiniCEX (PSM) as an integrated patient safety edu-cation and formative assessment package for IMGs, Residents and Medical Students in Workplace (clinical) settings.

Methods

An evidence-based Patient Safety Education Model was established from a comprehensive review of international patient safety, medical curricula and education literature. The PSM was developed, tested, refined and validated over a two-year period. Key stakeholders were engaged via a Think Tank. Ethics approval was gained for testing of the tool in OSCE, High/Low Fidelity Simulation and Clinical Settings.

The final Patient Safety MiniCEX Tool has 4 Competency Areas, 13 Competency Standards and 38 Competency Indicators. Reliability was achieved through standardisation of clinical scenarios and assessor and facilitator training.

Results

There were 150 participants recruited (including IMGs and their supervisors). Data was analysed from 2 eight-station OSCE rotations, 4 four-scenario simulation encounters and 60 patient encounters in clinical settings. Reliability modelling of OSCE and Simulation items reduced the Knowledge Items needed for acceptable reliability from 18 to 13. Areas where participants consistently performed at an unsatisfactory or borderline satisfactory standard were Managing Information, Clinical Judgement and Decision Making, Communication and Infection Control. Qualitative data from supervisors in clinical settings additionally provided validation of the poor ratings within Communication and Infection Control.

Applications

The PSM performs well in clinical and simulated settings. Innovation Booth features will include
interactive video rating using web-based tools.

Future Directions

International collaboration and engagement with potential participants interested in trialling or
replicating the PSM resource.