Team discussions may help reduce medical errors

Team discussion improved diagnostic, treatment accuracy among physician assistant students
Team discussion improved diagnostic, treatment accuracy among physician assistant students

SAN FRANCISCO — Group discussions implemented as part of interprofessional education training programs significantly improved diagnostic and treatment accuracy scores among physician assistant students, findings from a prospective pilot study indicate.

In response to the Institute of Medicine's goal to reduce medical errors, accrediting bodies including the accreditation of PA programs (ARC-PA), have begun developing standards of interprofessional education (IPE).  

Elana A. Min, PhD, PA-C, director of academic education for the physician assistant program at Rush University's College of Health Sciences in Chicago, Illinois, sought to determine the effect of these efforts in clinical scenarios. 

“It is of interest to investigate which types of interprofessional [IP] collaboration result in improved outcomes which will provide key data to help structure IPE training programs,” Min said during a poster session at the American Academy of Physician Assistant's 2015 meeting

To do this, she measured diagnostic and treatment scores among an IP team consisting of second year PA students, fourth year medical students and fourth year PharmD students (n=7) and homogeneous control groups consisting of either all PA students, all MD students, or all PharmD students (n=5 in each) before and after participating in IPE. 

Each group was administered three clinical cases of varying levels of difficulty. Students were asked to fill out an initial impression outlining a diagnosis and treatment program. They then participated in an discussion with an IP team, and completed a post-collaboration impression of their diagnosis and treatment program.

“Pre- and post-collaboration diagnosis and treatment scores were measured using a scoring rubric created through adaptation of a validated case instrument and the Delpi process,” Min said. 

Two-tailed t-tests were then used to compare mean changes in IP team pre- and post-collaboration scores for combined diagnosis and treatment, diagnosis only, and treatment only (n=21). 

“Each of these statistical tests found a significant improvement in IP group scores following collaboration,” Min said. 

Mean combined diagnosis and treatment scores were significantly higher post-collaboration (t[20]=5.404; P=<0.001) in the IP group, with similar findings for diagnosis only (t[20]=6.717; P<0.001) and treatment only (t[20]=3.908; P=0.001) scores. 

There were also statistically significant improvements in all of the same categories among the control groups (n=15; t[14]=4.44; P<0.001), Min found.

Overall, the IP groups had greater score improvements compared with control groups, but the difference was not statistically significant (t[34]=0.937; P=0.330).

“These results may support that collaboration alone, regardless of whether it is inter or intra-professional may be a key component in improving diagnostic and treatment accuracy,” Min said. 

She called for more studies to evaluated more variables of quality discussion that may influence diagnostic and treatment outcomes. 

Reference

  1. Min EA. “The Impact of Student Interprofessional Team Approach on Diagnostic and Treatment Accuracy.” Presented at: AAPA 2015. May 23-27, 2015. San Francisco, California. 
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