The RCA ReCAst: A Root Cause Analysis Simulation for the Interprofessional Clinical Learning Environment

Area of Science:

• Medical Education
• Patient Safety
• Healthcare Simulation

Background:

• Graduate medical education (GME) requires resident participation in patient safety event analysis.
• A shortage of institutional root cause analyses (RCAs) limits opportunities for this critical training.
• An interprofessional RCA simulation program was developed to address this educational gap.

Purpose of the Study:

• To implement and evaluate an institutionally sponsored, interprofessional RCA simulation program for all GME residency programs.
• To enhance resident competency in conducting patient safety investigations.
• To increase resident willingness to report adverse events.

Main Methods:

• Developed RCA simulations based on authentic adverse events, covering diverse areas like medications, communication, and procedures.
• Included residents and other healthcare professionals (nurses, pharmacists) in simulated RCA teams.
• Systematically progressed participants through the RCA process in small groups.

Main Results:

• 289 individuals from 18 residency programs participated.
• Significant improvement in identifying factors for RCA investigations (62% pre vs. 80% post, P = .02).
• Marked increase in the intent to "always report" adverse events (3% pre vs. 37% post, P < .001).

Conclusions:

• The RCA simulation program effectively enhanced GME trainees' ability to conduct patient safety investigations.
• The simulation significantly increased residents' intent to report adverse events.
• Expansion of the program to other GME sites and learners is planned.