Challenges in preparing safe practitioners themes and narrative data
| Categories | Narrative data |
|---|---|
| (iii) Culture of the clinical practice setting | ‘students go to medical and surgical units and are treated very poorly by the staff and having things said to them that are difficult. They see practices that are different than what they are taught or that are offensive’ (Nurse) ‘Students feel safe in the classroom. In the classroom there is an openness and/or opportunity for dialogue but in practice don't speak up, don't question. They're intimidated by medicine when they are in the clinical practice setting’ (Pharmacist) ‘Physicians usually have like a deeper medical background and are responsible for making … decisions about drugs and reasons for drugs and it's going to be harder for other members of the team to voice concerns about a medical diagnosis or treatment, because of the difference of roles.’ (Physician) |
| (iv) Formal vs informal teaching | ‘Patient safety is integrated into everything we do as clinical educators—are they giving proper hygiene? Oral care? Language and culture issues with our international students. These issues come up during clinical assignments and in post-clinical conferences.’ (Nurse) ‘We have a dedicated part time faculty member who leads the integration of patient safety through the whole curriculum.’ (Pharmacist). ‘(patient safety) teaching has happened but it's been mostly informal. Now there's been an increase in requirements to make it formal, to incorporate formal teaching. (Physician) |
| (v) Faculty preparation | ‘Different preceptors, different standards. You have preceptors who may feel threatened that the student may ask them complex questions and therefore will be very laid back and easy and pass the student. Other preceptors will say ‘Oh I hate students because I know they're going to ask me difficult questions.’ (Nurse) ‘I see preceptors where they really want to teach and how they deal with students in the setting and they want students to be really good. And then there are preceptors who are only doing it because they can put that in their resume and really don't care about it.’ (Pharmacist) ‘You are reliant on the clinicians that are involved in being preceptors or teachers—they have to have a good safety culture themselves and a good awareness of safety issues for sure.’ (Physician) |
| (vi) Authenticity | ‘no matter how much we try to simulate reality, the learning environment is very controlled. And then when they're out in that clinical setting it's the real world and it's increasingly complex and they have the responsibility now of being a registered nurse. Which you can't simulate really.’ (Nurse) ‘And I think the only way to teach about role, interprofessional conflict, working in teams is by being taught in the clinic in teams.’ (Pharmacist) ‘It hard to teach some of these patient safety situations in class. I think you need to be in the clinical environment and have teaching related to concrete examples.’ (Physician) |