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7 Layered Simulation: A Novel Approach to Medical Malpractice Education
Author(s) -
Schlicher Nathaniel
Publication year - 2008
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/j.1553-2712.2008.00131_7.x
Subject(s) - medicine , malpractice , likert scale , documentation , patient safety , medical education , family medicine , simulated patient , health care , psychology , computer science , developmental psychology , political science , law , economics , programming language , economic growth
Overview: We present a novel approach to the use of simulation in medical education with a two‐event layered simulation. A patient care simulation with an adverse outcome was followed by a delayed simulated deposition. Process: Senior residents in an academic emergency medicine program were solicited as simulation research volunteers. Other than stating that the research involved adverse outcomes, no identifying information was given. Seven volunteers participated in a simulation involving a forced error (nurse confederate gave an incorrect medication dose). Based on the initial simulation, one physician completed a simulated deposition in a teaching conference six weeks later conducted by a licensed attorney with malpractice experience. The audience, consisting of residents, attendings, and students, watched a recording of the patient care, witnessed the deposition, and evaluated the experience using a 13 question survey with five‐point Likert scales. Outcome: Participants felt that, overall, the training program was a useful educational tool (average Likert score of 4.63) that would change aspects of their practice (3.31). Participants stated that they would be more careful in their documentation (3.88), review high risk situations with staff (4.00), and monitor more carefully for errors (3.95). Overall, there was a degree of increased fear of the litigation process (3.95), but participants felt they would improve the risk profile of their practices (3.70). Conclusion: A novel approach to medical education was successful in changing attitudes and provided an expanded educational experience for participants. Layered simulation can be successfully incorporated into educational programs for numerous issues including medical malpractice.