title: Patients and families as teachers: a mixed methods assessment of a collaborative learning model for medical error disclosure and prevention.
abstract: Despite growing interest in engaging patients and families (P/F) in patient safety education, little is known about how P/F can best contribute. We assessed the feasibility and acceptability of a patient-teacher medical error disclosure and prevention training model.
  
  
  
  We developed an educational intervention bringing together interprofessional clinicians with P/F from hospital advisory councils to discuss error disclosure and prevention. Patient focus groups and orientation sessions informed curriculum and assessment design. A pre-post survey with qualitative and quantitative questions was used to assess P/F and clinician experiences and attitudes about collaborative safety education including participant hopes, fears, perceived value of learning experience and challenges. Responses to open-ended questions were coded according to principles of content analysis.
  
  
  
  P/F and clinicians hoped to learn about each other's perspectives, communication skills and patient empowerment strategies. Before the intervention, both groups worried about power dynamics dampening effective interaction. Clinicians worried that P/F would learn about their fallibility, while P/F were concerned about clinicians' jargon and defensive posturing. Following workshops, clinicians valued patients' direct feedback, communication strategies for error disclosure and a 'real' learning experience. P/F appreciated clinicians' accountability, and insights into how medical errors affect clinicians. Half of participants found nothing challenging, the remainder clinicians cited emotions and enormity of 'culture change', while P/F commented on medical jargon and desire for more time. Patients and clinicians found the experience valuable. Recommendations about how to develop a patient-teacher programme in patient safety are provided.
  
  
  
  An educational paradigm that includes patients as teachers and collaborative learners with clinicians in patient safety is feasible, valued by clinicians and P/F and promising for P/F-centred medical error disclosure and prevention training.
authors.affiliation: Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Boston, Massachusetts, USA Department for Neuropediatrics and Muscular Disorders, Universitätsklinikum Freiburg, Freiburg, Germany.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Langer
authors.affiliation: Division of General Internal Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: William
authors.initials: W
authors.lastname: Martinez
authors.affiliation: Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Boston, Massachusetts, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Browning
authors.affiliation: Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Boston, Massachusetts, USA.
authors.forename: Pamela
authors.initials: P
authors.lastname: Varrin
authors.affiliation: Department of Social Work, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Sarnoff Lee
authors.affiliation: Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Boston, Massachusetts, USA Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
authors.forename: Sigall K
authors.initials: SK
authors.lastname: Bell
mesh_terms: D000328:Adult; D004493:Education; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D000073919:Interdisciplinary Placement / Q000379:methods*; D008297:Male; D019300:Medical Errors / Q000517:prevention & control*; D008875:Middle Aged; D017145:Models, Educational; D061214:Patient Safety; D010361:Patients / Q000523:psychology; D014342:Truth Disclosure
keywords: Health professions education; Patient education; Patient-centred care; Safety culture; Simulation