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Clinical clerkship students' perceptions of (un)safe transitions for every patient. Acad Med 2014 Mar;89(3):477-81

Date

01/23/2014

Pubmed ID

24448048

DOI

10.1097/ACM.0000000000000153

Scopus ID

2-s2.0-84894662214   7 Citations

Abstract

PURPOSE: As calls for training and accreditation standards around improved patient care transitions have recently increased, more publications describing medical student education programs on care transitions have appeared. However, descriptions of students' experience with care transitions and the sender/receiver communication that supports or inhibits them are limited. To fill this gap, the authors developed this project to understand students' experiences with and perceptions of care transitions.

METHOD: At the start of a patient safety intersession at the Medical College of Wisconsin (2010), 193 third-year medical students anonymously wrote descriptions of critical incidents related to care transitions they had witnessed that evoked a strong emotional reaction. Descriptions included the emotion evoked, clinical context, and types of information exchanged. The authors analyzed the incident descriptions using a constant comparative qualitative methodology.

RESULTS: Analysis revealed that 111 of the 121 medical students (92%) who disclosed emotional responses had strong negative reactions to unsuccessful transitions, experiencing frustration, irritation, fear, and anger. All of these negative emotions were associated with lack of or poor communication between the sender and receiver: ambiguous roles and responsibilities, insufficient detailing of the patient's medical course, inadequate identification of the people involved in the transition, incomplete delineation of what the patient needed, and unclear reasons for the transition.

CONCLUSIONS: Third-year medical students' descriptions of care-transition incidents reveal high rates of strong negative emotions and of communication gaps that may adversely affect patient care. Results support curricular innovations that align students' needs and experiences with safe patient care transitions.

Author List

Koch PE, Simpson D, Toth H, Marcdante K, Densmore E, Young S, Weisgerber M, Morzinski JA, Havas N

Authors

Emily M. Densmore MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin
Karen J. Marcdante MD Professor in the Pediatrics department at Medical College of Wisconsin
Heather Toth MD Professor in the Medicine department at Medical College of Wisconsin
Staci A. Young PhD Associate Professor in the Family Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Attitude of Health Personnel
Clinical Clerkship
Communication
Continuity of Patient Care
Humans
Patient Handoff
Qualitative Research
Students, Medical