Elsevier

Surgery

Volume 152, Issue 1, July 2012, Pages 26-31
Surgery

Original Communication
Safety skills training for surgeons: A half-day intervention improves knowledge, attitudes and awareness of patient safety

https://doi.org/10.1016/j.surg.2012.02.006Get rights and content

Background

Education and training of health care professionals is necessary to achieve sustainable improvements in patient safety. Despite its inherently risky nature, little training specifically in safety has been conducted in the surgical disciplines. In this study we explored the effects of a safety skills training program on surgical residents' knowledge, attitudes, and awareness of patient safety.

Methods

A half-day training program incorporating safety awareness, analysis, and improvement skills was delivered to surgical residents from 19 hospitals in London, United Kingdom. Participants were assessed in terms of safety knowledge (MCQs) and attitudes to safety (validated questionnaire; scale 1 to 5) before and after training. To determine long-term effects, 6 months after training participants identified and reported on observed safety events in their own workplace by using an observational form for data collection.

Results

A total of 27 surgeons participated in the training program. Knowledge of safety significantly improved after the course (mean pre = 45.26% vs mean post = 70.59%, P < .01) as did attitudes to error analysis and improving safety (mean pre 3.50 vs mean post 3.97, P < .001) and ability to influence safety (mean pre 3.22 vs mean post 3.49, P < .01). After the course, participants reported richer, detailed sets of observations demonstrating enhanced understanding, recognition, and analysis of patient safety issues in their workplace.

Conclusion

Safety skills training with positive educational outcomes can be delivered in a half day. Such a course may allow patient safety to be integrated into any curriculum, thereby training the next generation of the healthcare workforce to maintain the safety momentum.

Section snippets

Setting and participants

The training took place in a London U.K. Teaching Hospital, delivered by 4 faculty members (2 surgeons and 2 patient safety experts) from the National Institute of Health Research Imperial Centre for Patient Safety and Service Quality. All General Surgery Residents (PGY3-8) from 19 hospitals in London, United Kingdom (n = 48) were invited to attend the training.

The training program

A 3-hour course on safety skills was developed in which we aimed to equip participants with safety awareness skills, safety analysis

Results

A total of 27 surgeons (male = 17, female = 10) from 19 hospitals across London attended the training program (total population of surgical residents in the 19 hospitals = 48). All surgeons who participated were residents (PGY3-8) in the specialty of general surgery.

Discussion

Improving quality and safety is one of the toughest problems facing medicine today. To boost safety culture in health care, it is essential that the next generation of health care professionals is adequately trained to recognize, prevent, and mitigate error. With this in mind, we developed a comprehensive but feasible package that delivers effective training in safety awareness, safety analysis, and safety improvement skills in a half-day with no special resources (such as simulation), making

References (31)

  • House of Commons Health Committee. Patient safety. Sixth Report of Session 2008-09. House of Commons. London: The...
  • A.B. Haynes et al.

    A surgical safety checklist to reduce morbidity and mortality in a global population

    N Engl J Med

    (2009)
  • D.C. Aron et al.

    Educating physicians prepared to improve care and safety is no accident: it requires a systematic approach

    Qual Saf Health Care

    (2002)
  • R. Patey et al.

    Patient safety: helping medical students understand error in healthcare

    Qual Saf Health Care

    (2007)
  • L.W. Hall et al.

    Effectiveness of patient safety training in equipping medical students to recognise safety hazards and propose robust interventions

    Qual Saf Health Care

    (2010)
  • Cited by (27)

    • Patient Safety Attitude of Nurses Working in Surgical Units: A Cross-Sectional Study in Turkey

      2020, Journal of Perianesthesia Nursing
      Citation Excerpt :

      The study reported a significant increase in workers' attitudes after training. Arora et al46 reported that a 3-hour training session, given to surgeons working in 19 different hospitals in London, on interventions about increasing safety awareness and safety led to the surgeons becoming more aware of safety and also increased their knowledge about the issue. Similarly, studies examining the reporting of medical errors and patient safety culture in health workers have emphasized that institutions should provide training for their employees or allow them to include in an orientation program to ensure the safety culture.31,43,47,48

    • Health care professionals’ skills regarding patient safety

      2016, Medicina (Lithuania)
      Citation Excerpt :

      Safety skills include non-technical skills such as leadership, teamwork, communication, co-operation, situation awareness and decision making, and also go beyond these to include other behaviors and attributes such as conscientiousness, vigilance and humility. Importantly, these skills have been recognized as both crucial to patient safety and also as highly trainable [1]. Non-technical skills support technical skills such as systematic assessment, fluid management during simulation, urethral catheterization, central venous catheter insertion performed during resuscitation, or carrying out surgery [3].

    • An overview of research priorities in surgical simulation: What the literature shows has been achieved during the 21st century and what remains

      2016, American Journal of Surgery
      Citation Excerpt :

      Other high-risk industries, such as aviation and the military, have, thus, developed Crew Resource Management team training programs to help create more cohesion and effective responses among teams; these types of training programs, however, remain niche players in surgical education and practice.25 Given that surgeons are fairly accurate at self-assessing their technical skills but lack the necessary insight to self-assess their own NTS,26 team training and assessment may act as the bridge between learning technical skills on bench-top/virtual reality simulation and overall competence in the OR. Indeed, implementation of team training programs has been associated with a reduction in surgical mortality.27

    • Advances in Teaching and Assessing Nontechnical Skills

      2015, Surgical Clinics of North America
      Citation Excerpt :

      These demonstrations can be live, for example via live role play within the training, or recorded, for example via simulated video clips that showcase appropriate or inappropriate team skills in the OR. An example of a demonstration-based approach was provided by Arora and colleagues,19 who incorporated a half-day training session into regular general surgical residents’ teaching rotations. Nontechnical skills were incorporated using the revised NOTECHS (Nontechnical Skills) framework into a training curriculum that covered basic safety skills, incident analysis, checklist usage, and briefings/debriefings in the OR.

    View all citing articles on Scopus
    View full text