Paul F. Griner, MD
Potential Financial Conflicts of Interest: None disclosed.
Griner PF. Graduate Medical Education and Patient Safety. Ann Intern Med. 2007;146:685-686. doi: 10.7326/0003-4819-146-9-200705010-00017
Download citation file:
Published: Ann Intern Med. 2007;146(9):685-686.
TO THE EDITOR:
In their recent Quality Grand Rounds article, Shojania and colleagues (1) described a case in which problems in communication and supervision among and between residents and an attending physician led to the possibly preventable death of an 88-year-old woman with intestinal obstruction. The authors suggested how one might minimize sign-out and handoff problems, reduce tension between service and supervision, and encourage trainees to call for help.
The case description noted that a fourth-year medical student offered to insert a nasogastric tube because she wanted to learn how to perform the procedure. Miscommunication between the student and the supervising nurse resulted in the insertion of a feeding tube instead—just one in a sequence of errors that ultimately led to the death of the patient. In their discussion of this portion of the case, the authors overlooked an opportunity to comment on approaches to “learning by doing” through the use of simulation. Soon it will no longer be necessary for medical students to perform their first procedures on actual patients. Simulation laboratories in medical schools will provide the opportunity for students, trainees, and faculty to achieve core competencies in invasive procedures without the risk for harm to patients. Consensus statements have been developed about the use of such tools as simulation and virtual reality for teaching and evaluating these competencies (2). How the current and future use of these technologies will replace the apprenticeship model for developing procedural skills should be of interest to all medical educators (3).
to gain full access to the content and tools.
Learn more about subscription options.
Register Now for a free account.
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only