Simulation teaches students how to respond to medical errors

School of Health Sciences and School of Nursing students and faculty members
Students and faculty members from the School of Health Sciences, Frank H. Netter MD School of Medicine and the School of Nursing took part in a medical simulation training exercise on April 6.

April 17, 2013 - A patient receives care from a health care team, so when a medical error occurs, it’s best that the entire team is involved in disclosing it to the patient.

That’s not always easy. To address this important issue, Quinnipiac University held a daylong training exercise in April to help students—future health professionals from several fields—learn how to work together to disclose an error to a patient and family member and make a plan to correct it.

The interprofessional event was the first of its kind at Quinnipiac, and also the first of many more to come. The event included 20 student volunteers from programs in athletic training, cardiovascular perfusion, diagnostic imaging, nursing, occupational therapy, physical therapy and physician assistant.

Teams of students faced a scenario involving an injured BMX bike rider (a patient simulation mannequin) and a parent, played by a medical actor. Each team encountered medical errors related to their respective fields, such as administering the wrong prescription, using contaminated equipment or applying the wrong physical therapy treatment, and the ways each team member contributed to the error.

“We work as a team. We must all acknowledge our personal role and acknowledge the error,” says Cory A. Boyd, associate professor of nursing. “We are trying to teach our students that they need to do this disclosure in a blame-free way.”

Boyd was one of nearly two-dozen faculty and staff who developed the training over six months, as a program of the Center for Interprofessional Healthcare Education at Quinnipiac. The center is collaboration among faculty in the School of Nursing, the School of Health Sciences and the Frank H. Netter MD School of Medicine. The center’s interprofessional simulation learning and assessment committee, with support from the Robert Wood Johnson New Careers in Nursing grant, organized the event.

Students developed communication skills around possible patient and family reactions, such as anger or sadness. They discussed new trends in disclosing errors, how to prevent errors and how to begin regaining the trust of the patients.

Informing patients of mistakes is the ethical thing to do. In addition, hospitals that disclose errors face fewer lawsuits and have smaller settlements, Boyd explains.

“What patients want by and large is a sincere apology and to believe the medical staff did everything they could to prevent this problem,” Boyd says. The patient also is considered an equal partner in his or her plan of care and must be involved in the changes that might have to occur because of an error.

Students said they enjoyed working with peers in other health care fields. Many students, for example, had never been exposed to the ECMO machine, used to oxygenate the blood and rest the lungs, said Michael Smith, professor and director of the cardiovascular perfusion program.

“We wanted to have many health professions here to interact and recognize each other’s role in health care delivery,” Smith said.

“It was nice to not only learn about other professions, but also how they approach a patient and how they approach the issues a patient faces,” said Brandon Lynn, a student in the accelerated BSN program and a Robert Wood Johnson New Careers in Nursing grant fellow. “They have a different set of goals in mind, but we’re all working together to help the patient. When you go out in the real world, that’s what you will be doing.”

Students said the daylong simulation was an eye-opening experience and want to do more of these exercises.

“We’re very excited about expanding the opportunity to other students and making it a more regular occurrence,” said Kim Hartmann, chair of the Department of Occupational Therapy and chair of the Center for Interprofessional Healthcare Education.

Darlene Rogers, lab coordinator for nursing who spearheaded the event as committee chair, said, “This allowed us to work together and really built excitement and enthusiasm for interprofessional learning.”