Title

Beyond "see one, do one, teach one": toward a different training paradigm

Authors

Authors

J. M. Rodriguez-Paz; M. Kennedy; E. Salas; A. W. Wu; J. B. Sexton; E. A. Hunt;P. J. Pronovost

Abbreviated Journal Title

Postgrad. Med. J.

Keywords

INTENSIVE-CARE-UNIT; HUMAN PATIENT SIMULATOR; SERIOUS MEDICAL ERRORS; HOUSE OFFICERS LEARN; ADVERSE EVENTS; NONTECHNICAL SKILLS; HOSPITALIZED-PATIENTS; CLINICAL-PERFORMANCE; RESIDENT PERFORMANCE; SLEEP-DEPRIVATION; Medicine, General & Internal

Abstract

In the process of acquiring new skills, physicians-in-training may expose patients to harm because they lack the required experience, knowledge and technical skills. Yet, most teaching hospitals use inexperienced residents to care for high-acuity patients in complex and dynamic environments and provide limited supervision from experienced clinicians. Multiple efforts in the last few years have started to address the problem of patient safety. Examples include voluntary incident-reporting systems and team training workshops for practising clinicians. Fewer efforts have addressed the deficits in training new physicians, especially related to knowledge, skills and competence. The current apprenticeship or "see one, do one, teach one" model is insufficient because trainees learn by practising on real patients, which is particularly an issue when performing procedures. Residents have expressed that they do not feel adequately trained to perform procedures safely by themselves. In this paper, we conduct an informal review of the impact of current training methods on patient safety. In addition, we propose a new training paradigm that integrates competency-based knowledge and clinical skills, with deliberate attitudinal and behavioural changes focused on patient safety in a safe medically simulated environment. We do so with the hope of creating a better marriage between the missions of training and patient safety.

Journal Title

Postgraduate Medical Journal

Volume

85

Issue/Number

1003

Publication Date

1-1-2009

Document Type

Article

Language

English

First Page

244

Last Page

249

WOS Identifier

WOS:000266974900005

ISSN

0032-5473

Share

COinS