PART 3—PATIENT SAFETY ORGANI- ZATIONS AND PATIENT SAFETY WORK
Health Profession Education for Patient Safety” Blink or Think? Pat Croskerry MD, PhD The Safety...
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Transcript of Health Profession Education for Patient Safety” Blink or Think? Pat Croskerry MD, PhD The Safety...
Pat Croskerry MD, PhD
The Safety CompetenciesEnhancing Patient Safety Across the Health Professions
Ottawa, October 2007
Health Profession Education for Patient Safety: Blink or Think?
Canadian inter-professional competency-based framework
(institutional)
Medicine Nursing Pharmacy The therapy groups (PT, OT, RT)
Four spheres ofFour spheres of educationaleducational influenceinfluence
Educators
Nurses
Managers
LegalSystem
Federal Government
Media
MedicalStudents
Supervisors
Administrators
GeneralPublic
CurrentPractitioners
Paramedics in Training
EquipmentSuppliers
Residents
HealthAdvisors
ProfessionalGroups
Ethicists
Local Government
AdvisoryGroups
PharmacyStudents
Multidisciplinary Training Groups
Blunt End
Socio-Legal Groups
Government
Provincial Government
To identify the key knowledge, skills and attitudes related to patient safety competencies
for all health-care professionals
Specific Abilities underlying Critical Thinking to know and understand Dual Process Theory to recognize distracting stimuli, propaganda, bias, irrelevance to identify, analyze, and challenge assumptions in arguments to be aware of cognitive fallacies and poor reasoning to recognize deception, deliberate or otherwise to assess credibility of information to monitor and control own thought processes to monitor and control own affective state to be aware of the impact of fatigue and sleep deprivation on decision making to be able to imagine and explore alternatives to effectively work through problems to be aware of the importance of the context under which decisions are made to make effective decisions to anticipate the consequences of decisions
‘‘Those who are responsible for teaching students and Those who are responsible for teaching students and residents …should try to identify clearly, separate, residents …should try to identify clearly, separate, and then extract these critically important cognitive and then extract these critically important cognitive
tasks from courses that encompass myriad unrelated tasks from courses that encompass myriad unrelated skills and knowledge..’skills and knowledge..’
Kassirer, 1995
System 1(intuitive)
Cognitive style Cognitive style HeuristicHeuristicCognitive awareness Cognitive awareness LowLowCost Cost LowLowAutomaticity Automaticity HighHighRate Rate FastFastReliability Reliability LowLowErrors Errors UsuallyUsuallyEffort Effort LowLowPredictive power Predictive power LowLowEmotional component Emotional component HighHighScientific rigour Scientific rigour LowLow
System 2System 2 (analytical) (analytical) SystematicSystematic HighHigh HighHigh LowLow SlowSlow HighHigh FewFew HighHigh HighHigh LowLow HighHigh
BlinkBlink Malcolm Gladwell (2005)Malcolm Gladwell (2005)
‘We really only trust conscious decision making. But there are moments, particularly in times of stress, when haste does not make waste, when our snap judgments and first impressions can offer a much better means of making sense of the world.
The first task of Blink is to convince you of a simple fact: decisions made very quickly can be every bit as good as
decisions made cautiously and deliberately’
P 14P 14
ThinkThink Michael Legault (2006)Michael Legault (2006)
‘The technique by which we make good decisions and produce good work is a nuanced and interwoven mental process
involving bits of emotion, observation, intuition, and critical reasoning. The emotion and intuition are the easy, “automatic”
parts, the observation and critical reasoning skills the more difficult, acquired parts. The essential background to all this is a
solid base of knowledge.’
P 12P 12
ContextAmbient conditionsModular responsivityTask difficultyTask ambiguityAffective state
EducationTrainingCritical thinkingLogical competenceRationalityFeedbackIntellectual ability
Pattern Recognition
Repetition
Rationaloverride
Dysrationaliaoverride Calibration Response
Patient SafetyProblem
PatternProcessor
RECOGNIZED
NOTRECOGNISED
System
11
System
22
3 Features of the Model3 Features of the Model
Repetitive operations of System 2 Repetitive operations of System 2 System 2 override of System 1System 2 override of System 1 System 1 override of System 2System 1 override of System 2
ContextAmbient conditionsModular responsivityTask difficultyTask ambiguityAffective state
EducationTrainingCritical thinkingLogical competenceRationalityFeedbackIntellectual ability
Pattern Recognition
Repetition
Rationaloverride
Dysrationaliaoverride Calibration Response
Patient SafetyProblem
PatternProcessor
RECOGNIZED
NOTRECOGNISED
System
11
System
22
Repetitive Operations of System 2Repetitive Operations of System 2
KatecheoKatecheo Allows us to avoid redundancyAllows us to avoid redundancy Saves considerable time and resourcesSaves considerable time and resources Frees up our cognitive spaceFrees up our cognitive space Danger of being ‘too automatic’Danger of being ‘too automatic’
ContextAmbient conditionsModular responsivityTask difficultyTask ambiguityAffective state
EducationTrainingCritical thinkingLogical competenceRationalityFeedbackIntellectual ability
Pattern Recognition
Repetition
Rationaloverride
Dysrationaliaoverride Calibration Response
Patient SafetyProblem
PatternProcessor
RECOGNIZED
NOTRECOGNISED
System
11
System
22
System 2 override of System 1System 2 override of System 1
Feral vigilanceFeral vigilance Avoiding gut reactionAvoiding gut reaction Stop and thinkStop and think Sleep on itSleep on it
ContextAmbient conditionsModular responsivityTask difficultyTask ambiguityAffective state
EducationTrainingCritical thinkingLogical competenceRationalityFeedbackIntellectual ability
Pattern Recognition
Repetition
Rationaloverride
Dysrationaliaoverride Calibration Response
Patient SafetyProblem
PatternProcessor
RECOGNIZED
NOTRECOGNISED
System
11
System
22