Using Simulation Training to Teach Residents How to Write Readable and Accurate Incident Reports (1090-002275) (Research Abstract Professor Rounds: Group 4)
Start time: Thursday, January 28, 2021, 1:00 PM End time: Thursday, January 28, 2021, 2:00 PM Session Type: Research Abstracts (Completed Studies)
When an incident occurs at the clinical site, involved parties have to promptly submit an incident report. The Multi-Professional Patient Safety Curriculum Guide (1) states that it is important to consider what happened, why it happened, and what can be done to prevent the incident from happening again. To scientifically investigate an incident, it is vital to understand the facts. However, reports from health care providers often lack sufficient information about the facts, especially since medical incidents tend to be complicated. They are also often written subjectively since their reporting documents tend to be open-ended. As a result, incident reports are difficult to read and it is challenging to collect facts accurately (2). In Japan, medical students and residents have little opportunity to be educated on how to write incident reports accurately. In this study, we developed simulation training to improve incident report writing and evaluated the effectiveness of the training.
Residents attended a 60-minute training. (a) Trainees watched a three-minute video in which the doctor ordered medications without confirming drugs brought by the patient; the nurse ended up dispensing an incompatible drug. (b) Trainees spent 10 minutes creating a report from the standpoints of the doctor and nurse, writing the report in an open-ended document that simulated our hospital reporting system. (c) Trainees commented on each other’s report for five minutes. (d) The instructor provided writing tips—include 5W1H (When, Where, Who, What, Why, How); itemize sentences based on time of events; keep each sentence short; include a subject and predicate in each sentence. (e) Trainees spent another 10 minutes improving their report using the tips. (f) The instructor presented a model example against which trainees cross-checked their improved report. Post-training, feedback was obtained using a Likert scale questionnaire and comments collected using ARCS model (3).
Of the 57 trainees who attended the training, 56 agreed to this study and had their feedback analyzed. Ninety-eight percent (n = 55) of them declared that this is their first time receiving training on how to write a report. Results of the feedback based on ARCS model are as follows. Attention and Relevance: All trainees (n = 56) were interested in this training and found it necessary. All trainees found it relevant and useful for their clinical careers. Confidence: Simulation allowed all trainees (n = 56) to visualize how to write incident reports in the future. However, 29% (n = 16) of them were not confident about implementing it. Satisfaction: 98% (n = 55) of them were satisfied with the simulation. 93% (n = 52) of them wish to receive follow-up training. Comments were mostly positive: “It was great to be able to create reports from the perspective of both doctors and nurses.” “It was good that the points for improving the report were clarified.” “I want to practice a few times.”
Simulation training is useful for trainees to learn and visualize how to write readable and accurate incident reports. Since 98% of them had no experience in creating reports, the simulation was novel and was considered to have attracted attention (Attention). The video used in the training presented common errors that trainees can learn from. As residents may face situations where they are required to write incident reports, the training helped trainees become aware of its importance and relevance (Relevance). During the simulation, trainees were given opportunities to improve their reports using the tips and feedback given, allowing them to visualize what it is like to write an accurate and factual report. That said, they had only one practice round, making it hard to build the confidence needed to write reports independently (Confidence). Since Satisfaction was high, it seems Confidence can be enhanced in the future by providing follow-up training using other incident cases.