TY - JOUR
T1 - Clinical clerkship students' perceptions of (un)safe transitions for every patient
AU - Koch, Paul E.
AU - Simpson, Deborah
AU - Toth, Heather
AU - Marcdante, Karen
AU - Densmore, Emily
AU - Young, Staci
AU - Weisgerber, Michael
AU - Morzinski, Jeffrey A.
AU - Havas, Nancy
PY - 2014/3
Y1 - 2014/3
N2 - PURPOSE: As calls for training and accreditation standards around improved patient care transitions have recently increased, more publications describing medical student education programs on care transitions have appeared. However, descriptions of students' experience with care transitions and the sender/receiver communication that supports or inhibits them are limited. To fill this gap, the authors developed this project to understand students' experiences with and perceptions of care transitions. METHOD: At the start of a patient safety intersession at the Medical College of Wisconsin (2010), 193 third-year medical students anonymously wrote descriptions of critical incidents related to care transitions they had witnessed that evoked a strong emotional reaction. Descriptions included the emotion evoked, clinical context, and types of information exchanged. The authors analyzed the incident descriptions using a constant comparative qualitative methodology. RESULTS: Analysis revealed that 111 of the 121 medical students (92%) who disclosed emotional responses had strong negative reactions to unsuccessful transitions, experiencing frustration, irritation, fear, and anger. All of these negative emotions were associated with lack of or poor communication between the sender and receiver: ambiguous roles and responsibilities, insufficient detailing of the patient's medical course, inadequate identification of the people involved in the transition, incomplete delineation of what the patient needed, and unclear reasons for the transition. CONCLUSIONS: Third-year medical students' descriptions of care-transition incidents reveal high rates of strong negative emotions and of communication gaps that may adversely affect patient care. Results support curricular innovations that align students' needs and experiences with safe patient care transitions.
AB - PURPOSE: As calls for training and accreditation standards around improved patient care transitions have recently increased, more publications describing medical student education programs on care transitions have appeared. However, descriptions of students' experience with care transitions and the sender/receiver communication that supports or inhibits them are limited. To fill this gap, the authors developed this project to understand students' experiences with and perceptions of care transitions. METHOD: At the start of a patient safety intersession at the Medical College of Wisconsin (2010), 193 third-year medical students anonymously wrote descriptions of critical incidents related to care transitions they had witnessed that evoked a strong emotional reaction. Descriptions included the emotion evoked, clinical context, and types of information exchanged. The authors analyzed the incident descriptions using a constant comparative qualitative methodology. RESULTS: Analysis revealed that 111 of the 121 medical students (92%) who disclosed emotional responses had strong negative reactions to unsuccessful transitions, experiencing frustration, irritation, fear, and anger. All of these negative emotions were associated with lack of or poor communication between the sender and receiver: ambiguous roles and responsibilities, insufficient detailing of the patient's medical course, inadequate identification of the people involved in the transition, incomplete delineation of what the patient needed, and unclear reasons for the transition. CONCLUSIONS: Third-year medical students' descriptions of care-transition incidents reveal high rates of strong negative emotions and of communication gaps that may adversely affect patient care. Results support curricular innovations that align students' needs and experiences with safe patient care transitions.
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U2 - 10.1097/ACM.0000000000000153
DO - 10.1097/ACM.0000000000000153
M3 - Article
C2 - 24448048
AN - SCOPUS:84894662214
SN - 1040-2446
VL - 89
SP - 477
EP - 481
JO - Academic Medicine
JF - Academic Medicine
IS - 3
ER -