■ The healthcare system:
Building safer systems to enhance clinical care delivery
Reflections on managing risk
Type of activity: Narrative
Writing about one's personal experience encourages self-reflection and improves self-awareness. In this activity, learners are invited to reflect, in writing, on their experiences related to managing clinical risks for patients. Faculty may choose to have learners personally explore managing risk in practice (e.g. keep a journal), or share their narratives as part of an interactive small group session. Depending upon the nature of the activity, it may be appropriate to have learners review the domain content before or after participating in this exercise.
Note: Do not use open medico-legal cases. Patient and provider privacy and confidentiality must be maintained at all times. No names or other identifiers should be used.
Ask learners to write about an event they observed or were involved in during their medical training or practice that they feel might have placed a patient at risk. Alternatively, learners may want to write about an event that occurred to them as recipients of healthcare, or as an observer of a friend’s or family member’s healthcare experiences. The event may be one that they feel related to anticipation, recognition, or management of a patient safety risk.
Suggested content for the narrative:
- A description of the event
- An explanation of how this event placed a patient at risk
- The learner's reflections on the event including:
- If and how the event was recognized
- why and how the event occurred, for example, was the event due to
- action or inaction by an individual healthcare provider
- system failure(s)
- a combination of systems failure(s) and individual provider performance issues
- what changes or improvements they would make, if any
- how they felt at the time
- how they currently feel about the event
Suggestions to faculty
Faculty may choose to have learners share their narratives, if they feel comfortable doing so, as part of an interactive small group session.
Examples of questions that may be used to debrief the learners' experience:
- Were you personally involved in the event? Discuss.
- What, if any, workplace factors contributed to the event? (e.g. Was it during a handover? Did it involve a medication?)
- How aware was the healthcare provider(s) of what was going on around them? (situational awareness)
- How did the health care provider(s) recognize the safety problem and how did they respond?
- How did this event affect you?
- What did you take away from the event that you will use in the future?
- I would do something differently next time because…
CanMEDS: Medical Expert,