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Maintaining the highest levels of patient safety is a priority of healthcare organisations. However, although considerable resources are invested in improving safety, patients still suffer avoidable harm. The aims of this study are: (1) to examine the extent, range, and nature of patient safety research activities carried out in the Republic of Ireland (RoI); (2) make recommendations for future research; and (3) consider how these recommendations align with the Health Service Executive's (HSE) patient safety strategy. A five-stage scoping review methodology was used to synthesise the published research literature on patient safety carried out in the RoI: (1) identify the research question; (2) identify relevant studies; (3) study selection; (4) chart the data; and (5) collate, summarise, and report the results. Electronic searches were conducted across five electronic databases. A total of 31 papers met the inclusion criteria. Of the 24 papers concerned with measuring and monitoring safety, 12 (50%) assessed past harm, 4 (16.7%) the reliability of safety systems, 4 (16.7%) sensitivity to operations, 9 (37.5%) anticipation and preparedness, and 2 (8.3%) integration and learning. Of the six intervention papers, three (50%) were concerned with education and training, two (33.3%) with simplification and standardisation, and one (16.7%) with checklists. One paper was concerned with identifying potential safety interventions. There is a modest, but growing, body of patient safety research conducted in the RoI. It is hoped that this review will provide direction to researchers, healthcare practitioners, and health service managers, in how to build upon existing research in order to improve patient safety. [ABSTRACT FROM AUTHOR]

Background: Clinical education represents the most important formative period in undergraduate medical education. It is often criticised as haphazard and inefficient. Experience‐based learning (ExBL) is a novel clinical education design that utilises practices of support, learner participation and real patient learning to enhance students' development of vital professional capabilities. We introduced ExBL to address the challenges of a 50% reduction in clinical placement time that arose during the COVID‐19 pandemic. Approach: Final year medical students were assimilated into clinical teams as co‐workers to facilitate learning through participation rather than observation. Placement education was supported by an integrated case‐based learning and high‐fidelity simulation program. Real patient learning in workplace contexts was supported by a network of clinician mentors. Evaluation: A qualitative evaluation revealed that granting students co‐worker status strongly supported participatory learning and professional identity formation. Furthermore, the triangulation of placements with cognitive coaching and high‐fidelity simulation greatly enhanced skills development and students' sense of readiness for practice. Implications: Utilisation of ExBL significantly enhanced the quality of informal learning on clinical placements despite the reduced clinical placement time. In addition, the integration of cognitive coaching with simulation opportunities meant students were better prepared for meaningful participation as members of clinical teams. The introduction of ExBL increased the workload of clinical teachers. Moreover, favouring learning through participatory experience reduced exposure to more traditional formal bedside teaching encounters. Despite these challenges, we have adopted an ExBL model created in a crisis as our core educational design for our final year clinical programme. [ABSTRACT FROM AUTHOR]

Background: As compared to other domains of healthcare, little is known about patient safety incidents (PSIs) in prehospital care. The aims of our systematic review were to identify how the prevalence and level of harm associated with PSIs in prehospital care are assessed; the frequency of PSIs in prehospital care; and the harm associated with PSIs in prehospital care.Method: Searches were conducted of Medline, Web of Science, PsycInfo, CINAHL, Academic Search Complete and the grey literature. Reference lists of included studies and existing related reviews were also screened. English-language, peer-reviewed studies reporting data on number/frequency of PSIs and/or harm associated with PSIs were included. Two researchers independently extracted data from the studies and carried out a critical appraisal using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD).Results: Of the 22 included papers, 16 (73%) used data from record reviews, and 6 (27%) from incident reports. The frequency of PSIs in prehospital care was found to be a median of 5.9 per 100 records/transports/patients. A higher prevalence of PSIs was identified within studies that used record review data (9.9 per 100 records/transports/patients) as compared to incident reports (0.3 per records/transports/patients). Across the studies that reported harm, a median of 15.6% of PSIs were found to result in harm. Studies that utilized record review data reported that a median of 6.5% of the PSIs resulted in harm. For data from incident reporting systems, a median of 54.6% of incidents were associated with harm. The mean QATSDD score was 25.6 (SD = 4.1, range = 16-34).Conclusions: This systematic review gives direction as to how to advance methods for identifying PSIs in prehospital care and assessing the extent to which patients are harmed. [ABSTRACT FROM AUTHOR]

Background: There has been a considerable amount of research focused upon assessing doctor burnout. However, psychological resilience (PR) has been examined far less frequently. Aims: To examine the relationship between PR and burnout in Irish doctors in order to identify how PR can be improved—with a particular focus on how doctors can be empowered to strengthen their PR. Method: The ResMed PR survey and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) were distributed to doctors from an Irish teaching hospital. Results: A total of 322 completed online and paper surveys were received. Response rate for the paper surveys was 42.0% (168/400). Depersonalisation and personal accomplishment were significant predicators of job gratification (taking satisfaction from the job of a physician). Emotional exhaustion and personal accomplishment were significant predicators of protective attitudes (attitudes that promote or sustain PR; e.g. not taking things personally). Being a man was more positively related to protective attitudes than being a woman. Emotional exhaustion and personal accomplishment were significant predicators of protective practices (approaches to building/maintaining resilience; e.g. good time management). Conclusions: The research reported in this paper provides insights in to how healthcare leaders could empower frontline doctors to change how they work in order to allow them to improve their psychological resilience and help them to thrive, rather than just survive. [ABSTRACT FROM AUTHOR]

Background: A major barrier to safety improvement in primary care is a lack of safety data. The aims of this systematic meta-review (registration: CRD42021224367) were to identify systematic reviews of studies that examine methods of measuring and monitoring safety in primary care; classify the methods of measuring and monitoring safety in the included systematic reviews using the five safety domains of Vincent et al.'s framework and use this information to make recommendations for improving the measurement and monitoring of safety in primary care.Methods: Four databases (Medline, Academic Search Complete, Web of Science and CINAHL) and the grey literature were screened in November 2020, with searches updated in January 2021. Systematic reviews were included if they addressed the measurement of patient safety in primary care and were published in English. Studies were assessed using the Critical Appraisal Skills Programme for systematic reviews.Results: A total of 6904 papers were screened, with 13 systematic reviews included. A commonly reported method of measuring 'past harm' was through patient record review. The most frequent methods for assessing the 'reliability of safety critical processes' were checklists, observations and surveys of staff. Methods used to assess 'sensitivity to operations' included observation, staff surveys, interviews, focus groups, active monitoring and simulated patients. Safety climate surveys were a commonly used as an approach to assess 'anticipation and preparedness'. A number of the reviews concluded that safety data could, and should, be used for 'integration and learning'. The main limitation of the meta-review was that it was of systematic reviews only.Conclusions: Many of the methods for measuring and monitoring safety are readily available, quick to administer, do not require external involvement and are inexpensive. However, there is still a need to improve the psychometric properties of many measures. Researchers must support the development of psychometrically sound safety measures that do not over burden primary care practitioners. Policymakers must consider how primary care practitioners can be supported to implement these measures. [ABSTRACT FROM AUTHOR]

Context: Gender bias has been observed in the authorship and editorship of academic literature in varied medical specialties. This is important as peer‐reviewed publications, and participation on editorial boards, are closely related to academic productivity and advancement. The aim of this paper was to examine whether gender‐based disparities in authorship and editorship exist in leading medical education journals. Methods: A retrospective bibliometric review was conducted of articles published at eight different time‐points across a 49‐year time period (specifically: 1970, 1980, 1990, 2000, 2005, 2010, 2015 and 2019) in four leading medical education journals (Academic Medicine, BMC Medical Education, Medical Education and Medical Teacher). First and last (as a proxy for senior) author gender was determined for each article, along with the gender of the 2019 editorial board members of each journal. Chi‐square tests for trend were conducted to examine variations in author gender distributions over time, and binomial tests of proportions were conducted to examine gender distributions in authorship and editorship in 2019. Logistic regression analyses were carried out to determine factors that predicted the odds of authorship by women. Results: A total of 5749 articles were included. A significant trend of increased women as first and last authors was observed across all journals. The percentage of women first authors increased from 6.6% in 1970 to 53.7% in 2019 (P <.001), and women last authors increased from 9.5% in 1970 to 46% in 2019 (P <.001). Overall, the distributions of women first authors, last authors and editorial board members in 2019 indicated greater gender parity than many other fields of medicine. Conclusions: Positive progress towards gender parity has been made in medical education scholarship. However, future research and efforts are needed to ensure the continued participation, and highlighting, of women in medical education scholarship and to address other factors which may hinder academic advancement for women in this field. [ABSTRACT FROM AUTHOR]

Measures of Psychological Resilience (PR) for use with physician populations are lacking. The objective of this study is to develop and assess the validity and internal consistency of a survey designed to measure the perceived Psychological Resilience (PR) of physicians. A 37-item PR survey was developed and distributed to doctors from an Irish teaching hospital. Construct validity was established through a confirmatory factor analysis and internal consistency using Cronbach's alpha. Discriminant and convergent validity were assessed through correlating responses to the PR measure with the three subscales of the Maslach Burnout Inventory- Human Services Survey (MBI-HSS). A total of 292 responses to the survey were suitable for inclusion in the analysis. Confirmatory factor analysis resulted in an 18-item survey with three subscales: job gratification (alpha = 0.79), protective practices (alpha = 0.83), and protective attitudes (alpha = 0.81). There were significant negative correlations between the three subscales of the PR survey and the emotional exhaustion and depersonalization subscales of the MBI-HSS. There were significant positive correlation between each of the three subscales of the PR survey and the MBI-HSS personal accomplishment subscale. This study is the first stage in the development of an appropriate, valid and reliable survey for measuring the PR of physicians. [ABSTRACT FROM AUTHOR]