| Project
Description |
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| The University at Albany,
School of Public Health, in cooperation with Albany Medical College is conducting
a longitudinal, qualitative case study intended to explore how residents
are socialized around the issues of mistakes and how the best practices
associated with a "learning-type atmosphere" manifest themselves
among faculty and residents within two separate training environments. These
best practices refer to specific ways of thinking, interacting, and behaving
among these two groups that result generally in heightened systems thinking
and a greater propensity towards teamwork around patient safety, development
and promotion of a shared vision with respect to the definition and processing
of mistakes, and a personal approach to coping with and reducing mistakes
that is self-reflective, empathetic, and learning-oriented. |
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The specific aims of the study are five-fold:
- describe and compare how residents are socialized around
the issue of medical mistakes within a contemporary physician-training
environment;
- identify existing points within the training culture
that already contain elements of a "learning organization"
in relation to how mistakes are defined and processed by individuals;
- compare across two clinical specialties and two leadership
dyads of the residency training hierarchy opportunities and barriers
for incorporating specific activities associated with learning cultures
around the treatment of mistakes;
- explore potential gender and race/ethnicity differences
in how residents respond to and learn from mistakes and near miss situations;
and
- begin drafting a model "cultural template"
that can be validated in other residency settings for the purpose of
being used by residency programs nationally to assess and enhance their
everyday work contexts and culture with respect to residency socialization
around mistakes.
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| Data collection will focus on two
clinical specialties, i.e., surgery and medicine. It will consist of extended
fieldwork including observation of interactions between residents and attending
faculty in the course of their daily clinical work, examining how actual
mistakes play out within the residency environment, as well as one-on-one
interviews and focus groups with these same individuals. Meeting these aims
inform our understanding of how residency training environments can socialize
young physicians to think and act around mistakes in a way consistent with
what the Institute of Medicine Report and others call for in discussing
the need for "learning-type atmospheres." It will also provide
knowledge regarding the roles played by the surrounding work context and
culture in creating a learning-oriented physician. |
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Performance Sites:
University at Albany
School of Public Health
Dept. of Health Policy, Management, and Behavior
1 University Place
Rensselaer, NY 12144-3456
Albany Medical College
Albany Medical Center
42 New Scotland Avenue
Albany, NY 12203
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