Improving junior doctor medicine prescribing and patient safety: An intervention using personalised, structured, video-enhanced feedback and deliberate practice.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος:	Improving junior doctor medicine prescribing and patient safety: An intervention using personalised, structured, video-enhanced feedback and deliberate practice.
Συγγραφείς:	Green W; University of Leicester School of Business, University of Leicester, Leicester, UK., Shahzad MW; University of Leicester School of Business, University of Leicester, Leicester, UK., Wood S; University of Leicester School of Business, University of Leicester, Leicester, UK., Martinez Martinez M; Leicester General Hospital, University Hospitals of Leicester (UHL) NHS Trust, Leicester, UK., Baines A; Pilgrim Hospital Boston, United Lincolnshire Hospitals (ULH) NHS Trust, Boston, Lincolnshire, UK., Navid A; Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK., Jay R; School of Medicine, University of Nottingham, Nottingham, UK., Whysall Z; Department of Human Resource Management, Nottingham Business School, Nottingham Trent University, Nottingham, UK., Sandars J; Health Research Institute, Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, Lancashire, UK., Patel R; School of Medicine, University of Nottingham, Nottingham, UK.
Πηγή:	British journal of clinical pharmacology [Br J Clin Pharmacol] 2020 Nov; Vol. 86 (11), pp. 2234-2246. Date of Electronic Publication: 2020 May 18.
Τύπος έκδοσης:	Journal Article; Research Support, Non-U.S. Gov't
Γλώσσα:	English
Στοιχεία περιοδικού:	Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 7503323 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2125 (Electronic) Linking ISSN: 03065251 NLM ISO Abbreviation: Br J Clin Pharmacol Subsets: MEDLINE
Imprint Name(s):	Publication: Oxford : Wiley-Blackwell Original Publication: London, Macmillan Journals Ltd.
Ιατρικοί όροι (MeSH):	Medical Staff, Hospital* , Physicians*, Drug Prescriptions ; England ; Feedback ; Humans ; Practice Patterns, Physicians' ; Prospective Studies
Περίληψη:	Aims: This research investigated the effectiveness of an intervention for improving the prescribing and patient safety behaviour among Foundation Year doctors. The intervention consisted of simulated clinical encounters with subsequent personalised, structured, video-enhanced feedback and deliberate practice, undertaken at the start of four-month sub-specialty rotations. Methods: Three prospective, non-randomised control intervention studies were conducted, within two secondary care NHS Trusts in England. The primary outcome measure, error rate per prescriber, was calculated using daily prescribing data. Prescribers were grouped to enable a comparison between experimental and control conditions using regression analysis. A break-even analysis evaluated cost-effectiveness. Results: There was no significant difference in error rates of novice prescribers who received the intervention when compared with those of experienced prescribers. Novice prescribers not participating in the intervention had significantly higher error rates (P = .026, 95% confidence interval [CI] Wald 0.093 to 1.436; P = .026, 95% CI 0.031 to 0.397) and patients seen by them experienced significantly higher prescribing error rates (P = .007, 95% CI 0.025 to 0.157). Conversely, patients seen by the novice prescribers who received the intervention experienced a significantly lower rate of significant errors compared to patients seen by the experienced prescribers (P = .04, 95% CI -0.068 to -0.001). The break-even analysis demonstrates cost-effectiveness for the intervention. Conclusion: Simulated clinical encounters using personalised, structured, video-enhanced feedback and deliberate practice improves the prescribing and patient safety behaviour of Foundation Year doctors. The intervention is cost-effective with potential to reduce avoidable harm. (© 2020 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.)
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Grant Information:	Funding for Study 2 and 3 Academic Health Science Network; LEI0085 Health Education England; R.P.'s academic clinical lecturership National Institute for Health Research; Unrestricted Medical Education Grant (Study 1) Pfizer UK
Contributed Indexing:	Keywords: avoidable harm; deliberate practice; foundation training; junior doctors; patient safety; prescribing; video-enhanced feedback
Entry Date(s):	Date Created: 20200429 Date Completed: 20210728 Latest Revision: 20210728
Update Code:	20260130
PubMed Central ID:	PMC7576627
DOI:	10.1111/bcp.14325
PMID:	32343422
Βάση Δεδομένων:	MEDLINE

Περιγραφή
ISSN:	1365-2125
DOI:	10.1111/bcp.14325