PT - JOURNAL ARTICLE AU - Ian Thomas AU - Laura Nicol AU - Luke Regan AU - Jennifer Cleland AU - Drieka Maliepaard AU - Lindsay Clark AU - Kenneth Walker AU - John Duncan TI - Driven to distraction: a prospective controlled study of a simulated ward round experience to improve patient safety teaching for medical students AID - 10.1136/bmjqs-2014-003272 DP - 2015 Feb 01 TA - BMJ Quality & Safety PG - 154--161 VI - 24 IP - 2 4099 - http://qualitysafety.bmj.com/content/24/2/154.short 4100 - http://qualitysafety.bmj.com/content/24/2/154.full SO - BMJ Qual Saf2015 Feb 01; 24 AB - Background Distraction and interruption are endemic in the clinical environment and contribute to error. This study assesses whether simulation-based training with targeted feedback can improve undergraduate management of distractions and interruptions to reduce error-making. Design A prospective non-randomised controlled study. Methods 28 final year medical students undertook a simulated baseline ward round. 14 students formed an intervention group and received immediate feedback on distractor management and error. 14 students in a control group received no feedback. After 4 weeks, students participated in a post-intervention ward round of comparable rigour. Changes in medical error and distractor management between simulations were assessed with Mann-Whitney U tests using SPSS V.21. Results At baseline, error rates were high. The intervention group committed 72 total baseline errors (mean of 5.1 errors/student; median 5; range 3–7). The control group exhibited a comparable number of errors—with a total of 76 observed (mean of 5.4 errors/student; median 6; range 4–7). Many of these errors were life-threatening. At baseline distractions and interruptions were poorly managed by both groups. All forms of simulation training reduced error-making. In the intervention group the total number of errors post-intervention fell from 72 to 17 (mean 1.2 errors/student; median 1; range 0–3), representing a 76.4% fall (p<0.0001). In the control group the total number of errors also fell—from 76 to 44 (mean of 3.1 errors/student; median 3; range 1–5), representing a 42.1% reduction (p=0.0003). Conclusions Medical students are not inherently equipped to manage common ward-based distractions to mitigate error. These skills can be taught—with simulation and feedback conferring the greatest benefit. Curricular integration of simulated ward round experiences is recommended.