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Learning from errors: assessing final year medical students' reflection on safety improvement, five year cohort
Vicki Tully1,2, Douglas Murphy1, Evridiki Fioratou1
1Medical School, University of Dundee, Dundee, Scotland.
BMC Medical Education
|April 3, 2018
Summary
This study adapted the modified Mayo Evaluation of Reflection on Improvement tool (mMERIT) for medical students. The mMERIT tool demonstrated high reliability for assessing incident reviews, supporting workplace-based learning in patient safety.
Area of Science:
- Medical Education
- Quality Improvement
- Patient Safety
Background:
- Real incident reviews are valuable for medical student training.
- Existing methods for assessing reflection on quality improvement need adaptation.
- This study aimed to adapt and evaluate a reflection assessment tool for medical students.
Purpose of the Study:
- To adapt a published method for measuring resident doctors' reflection on quality improvement.
- To evaluate the adapted tool as an assessment for medical students.
- To assess the reliability and long-term sustainability of the tool.
Main Methods:
- A cohort study design was employed.
- Medical students received training via team-based learning and an online course.
- The modified Mayo Evaluation of Reflection on Improvement tool (mMERIT) reliability was analyzed using Generalizability G-theory over five years.
Main Results:
- 824 students completed incident reviews using real incidents.
- Inter-rater reliability was high, allowing for single-assessor use.
- Students using structured questions scored higher; initial concern rates decreased over time.
Conclusions:
- The mMERIT tool exhibits high reliability with a single rater.
- mMERIT effectively supplements student self-assessment and promotes professional practice development.
- Incident review using mMERIT facilitates workplace-based learning with real-life patient safety examples.
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