Pharmacy Student Knowledge and Communication of Medication Errors
Pharmacy Student Knowledge and Communication of Medication Errors
Objectives. To describe and evaluate pharmacy students' knowledge of and comfort in communicating, managing, and preventing medication errors.
Methods. Using a cross-sectional design, a survey instrument was administered to fifth-year pharmacy students. The survey instrument included both open- and close-ended questions to describe and examine factors associated with knowledge and comfort in communication of medication errors.
Results. Survey instruments were completed by 93 students (90% response rate). Nearly 80% reported not having received training in communicating medication errors. The perception of having more adequate training was related to greater knowledge in the communication of medication errors (p ≤ 0.001). Knowledge was also associated with students having greater comfort in communicating medication errors (p ≤ 0.05).
Conclusions. The need and value of additional training for pharmacy students in communicating medication errors was demonstrated. Educational interventions should be developed to provide consistent instruction on these communication issues.
The Accreditation Council for Pharmacy Education and the American Association of Colleges of Pharmacy both recognize the importance of patient safety as a core component of pharmacy education. The proceedings of a national stakeholder summit listed a recommendation that medication safety should be included in all professional school curriculums. The Food and Drug Administration's (FDA) Strategic Plan also supports pharmacists' understanding of the science of safety to ensure their active participation in the development, implementation, and/or evaluation of new initiatives to improve the consumer's safe use of medical products.
Limited research has been conducted on what pharmacists and pharmacy students have learned about medication safety, indicating considerable variation on the nature and depth of medication safety topics taught. Pharmacy programs providing medication safety instruction typically offer topics such as the nomenclature, frequency, cost, and morbidity/mortality associated with medication errors. One innovative program augmented the classroom approach by teaching medication safety and error reduction topics through student projects at institutional and community pharmacy sites. In this program, student knowledge and motivation to report and prevent errors was improved. It is not clear, however, what schools and colleges of pharmacy teach students about how they should communicate with patients and pharmacy staff members when medication errors occur, and how to prevent and/or intercept errors. Procedural knowledge of actions to take for the management and prevention of errors is vital for pharmacy students to effectively interact with patients and colleagues. During internships, pharmacists and pharmacy students often communicate about issues that arise, such as misunderstanding a prescriber's written or verbal prescription, giving a correctly filled prescription to the wrong patient, and assuming a prescription was checked when it had not been. Depending on the nature of the problem, medication errors often are received by patients as well as pharmacy personnel with considerable worry, fear, and disappointment. Poor communication between providers and patients can contribute to medication errors and other negative outcomes. Likewise, good provider-patient communication skills facilitate the development of trust between providers and patients, reduce patient anxiety, improve patient satisfaction, and minimize the frequency of lawsuits.
A clinician's lack of comfort with disclosure of medication errors is sometimes a barrier to good communication skills. Clinicians often are reluctant to report and disclose errors. Patients report that they typically are not given a clear explanation on what to do if an unanticipated medication outcome occurs, and they often feel distanced from health care staff members and organizations because they get few answers when a medication error does occur. Patients want errors to be disclosed and usually seek information about why the error happened, how the error's consequences are to be mitigated, and how recurrences are to be prevented. Harmful and serious medical errors are infrequently disclosed to patients. Multiple factors prevent providers from full disclosure of errors including apprehension that informing the patient of the error could lead to a lawsuit, damage to the clinician's reputation, job loss, and awkward clinical interactions.
When medication errors occur, negative outcomes result from poor communication. Pharmacy educators should explore how comfortable students are in communicating with colleagues and patients to manage and prevent medication errors. One study investigated the training of pharmacy students in communicating the management and prevention of medication errors. This qualitative study was comprised of 44 in-depth, semi-structured interviews of pharmacy students who were predominantly in their third, fourth, or fifth professional year of a 6-year pharmacy program. Students were interviewed on topics such as communication-related medication errors, and training on how to handle medication errors. Five main themes emerged from the interviews regarding medication errors and communication: (1) pressure to be perfect, (2) feeling comfortable talking about errors, (3) assuming and communicating responsibility for errors, (4) learning how processes can contribute to errors and their prevention, and (5) inadequate and inconsistent training on how to handle medication errors.
Our study aimed to replicate these latter findings using quantitative survey techniques among a more homogenous group of pharmacy students. We further evaluated the factors associated with pharmacy student knowledge and comfort on how to communicate, manage, and prevent medication errors. In addition, we hypothesized that students who perceived they had sufficient training in handling medication errors were more likely to have greater perceived knowledge about the procedures involved in the medication error process (hypothesis 1); and greater comfort in dealing with issues involving medication errors (hypothesis 2). We also expected to find that greater perceived knowledge about the procedures involved in the medication error process is associated with greater comfort in dealing with issues involving medication errors (hypothesis 3).
Abstract and Introduction
Abstract
Objectives. To describe and evaluate pharmacy students' knowledge of and comfort in communicating, managing, and preventing medication errors.
Methods. Using a cross-sectional design, a survey instrument was administered to fifth-year pharmacy students. The survey instrument included both open- and close-ended questions to describe and examine factors associated with knowledge and comfort in communication of medication errors.
Results. Survey instruments were completed by 93 students (90% response rate). Nearly 80% reported not having received training in communicating medication errors. The perception of having more adequate training was related to greater knowledge in the communication of medication errors (p ≤ 0.001). Knowledge was also associated with students having greater comfort in communicating medication errors (p ≤ 0.05).
Conclusions. The need and value of additional training for pharmacy students in communicating medication errors was demonstrated. Educational interventions should be developed to provide consistent instruction on these communication issues.
Introduction
The Accreditation Council for Pharmacy Education and the American Association of Colleges of Pharmacy both recognize the importance of patient safety as a core component of pharmacy education. The proceedings of a national stakeholder summit listed a recommendation that medication safety should be included in all professional school curriculums. The Food and Drug Administration's (FDA) Strategic Plan also supports pharmacists' understanding of the science of safety to ensure their active participation in the development, implementation, and/or evaluation of new initiatives to improve the consumer's safe use of medical products.
Limited research has been conducted on what pharmacists and pharmacy students have learned about medication safety, indicating considerable variation on the nature and depth of medication safety topics taught. Pharmacy programs providing medication safety instruction typically offer topics such as the nomenclature, frequency, cost, and morbidity/mortality associated with medication errors. One innovative program augmented the classroom approach by teaching medication safety and error reduction topics through student projects at institutional and community pharmacy sites. In this program, student knowledge and motivation to report and prevent errors was improved. It is not clear, however, what schools and colleges of pharmacy teach students about how they should communicate with patients and pharmacy staff members when medication errors occur, and how to prevent and/or intercept errors. Procedural knowledge of actions to take for the management and prevention of errors is vital for pharmacy students to effectively interact with patients and colleagues. During internships, pharmacists and pharmacy students often communicate about issues that arise, such as misunderstanding a prescriber's written or verbal prescription, giving a correctly filled prescription to the wrong patient, and assuming a prescription was checked when it had not been. Depending on the nature of the problem, medication errors often are received by patients as well as pharmacy personnel with considerable worry, fear, and disappointment. Poor communication between providers and patients can contribute to medication errors and other negative outcomes. Likewise, good provider-patient communication skills facilitate the development of trust between providers and patients, reduce patient anxiety, improve patient satisfaction, and minimize the frequency of lawsuits.
A clinician's lack of comfort with disclosure of medication errors is sometimes a barrier to good communication skills. Clinicians often are reluctant to report and disclose errors. Patients report that they typically are not given a clear explanation on what to do if an unanticipated medication outcome occurs, and they often feel distanced from health care staff members and organizations because they get few answers when a medication error does occur. Patients want errors to be disclosed and usually seek information about why the error happened, how the error's consequences are to be mitigated, and how recurrences are to be prevented. Harmful and serious medical errors are infrequently disclosed to patients. Multiple factors prevent providers from full disclosure of errors including apprehension that informing the patient of the error could lead to a lawsuit, damage to the clinician's reputation, job loss, and awkward clinical interactions.
When medication errors occur, negative outcomes result from poor communication. Pharmacy educators should explore how comfortable students are in communicating with colleagues and patients to manage and prevent medication errors. One study investigated the training of pharmacy students in communicating the management and prevention of medication errors. This qualitative study was comprised of 44 in-depth, semi-structured interviews of pharmacy students who were predominantly in their third, fourth, or fifth professional year of a 6-year pharmacy program. Students were interviewed on topics such as communication-related medication errors, and training on how to handle medication errors. Five main themes emerged from the interviews regarding medication errors and communication: (1) pressure to be perfect, (2) feeling comfortable talking about errors, (3) assuming and communicating responsibility for errors, (4) learning how processes can contribute to errors and their prevention, and (5) inadequate and inconsistent training on how to handle medication errors.
Our study aimed to replicate these latter findings using quantitative survey techniques among a more homogenous group of pharmacy students. We further evaluated the factors associated with pharmacy student knowledge and comfort on how to communicate, manage, and prevent medication errors. In addition, we hypothesized that students who perceived they had sufficient training in handling medication errors were more likely to have greater perceived knowledge about the procedures involved in the medication error process (hypothesis 1); and greater comfort in dealing with issues involving medication errors (hypothesis 2). We also expected to find that greater perceived knowledge about the procedures involved in the medication error process is associated with greater comfort in dealing with issues involving medication errors (hypothesis 3).