FINAL-YEAR medical students at a Scottish university are to be given training on a simulated real-life ward using actors to play the role of critically ill patients, in a bid to reduce potentially fatal errors by junior doctors.
Researchers from Aberdeen University and Raigmore Hospital in Inverness carried out a pilot scheme with a group of medical students who were assessed by senior staff using a one-way mirror to watch them in the ward.
The aim was to improve patient safety as junior doctors are deemed to more susceptible to multiple distractions that can lead to mistakes being made.
Students were presented with six realistic, time-critical distractions and interruptions that reflected situations they would face on a ward.
They included a radio switched on at 70 decibels, domestic vacuum cleaner being used, a doctor’s pager going off, an additional prescription task and a telephone call into the ward.
Professional actors played the roles of three patients – a man who had suffered a heart attack, an elderly female with pneumonia and an elderly, confused diabetic male. The students had to attend to the patients and ensure they were given the correct medication.
Ian Thomas, of the Highland Medical Education Centre, said: “All UK medical schools should consider this type of experience for their medical students.
“The results from the study are exciting and suggest real value in training medical students to manage distractions and interruptions.
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“The reduction in error rates is impressive and makes a strong argument for its adoption. “With targeted feedback error rates fell by 76 per cent, which potentially has important implications for patient safety.
“As a result of this study, we are now offering simulated ward round experiences to our final year medical students pre-graduation.”
He added: “The feedback was overwhelmingly positive. Among the comments from students was one which said, ‘I really hope this is a method of education that catches on because I feel it has been one of my most valuable learning experiences in fifth year so far and I would recommend it to absolutely everyone’.”
The study looked at whether simulated ward rounds, followed by targeted feedback could improve medical students’ abilities to cope with distractions and reduce error.
Fourteen medical students were taken on a simulated ward round, during which they made 72 errors, including using wrong patient blood results to make decisions and prescribing antibiotics to which the patient was allergic.
They were given feedback on how to best manage distractions to avoid errors. Another 14 students also undertook a simulated ward round experience, where they made 76 errors but received no feedback. Many of the errors made were life-threatening, such as prescribing allergic antibiotics and medication overdoses through mis-reading notes.
A month later both groups participated in another ward round. The error rate among those who received targeted feedback fell by 76 per cent, whereas the error rate among those who received no feedback fell by only 42 per cent.
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