Human Factors in Patient Safety for Higher Surgical Trainees

Introduction 

Human factors is defined as the scientific discipline concerned with understanding the interactions between humans and other elements of a complex system (Human Factors and Ergonomics Society, Accessed 2023). It encompasses what we know about people, their abilities and characteristics, and the environment in which they function (Human Factors and Ergonomics Society, Accessed 2023). Human Factors is an important means of analysing complex systems such as healthcare, with the aim of improving safety for all those impacted by the system (Human Factors and Ergonomics Society, Accessed 2023). Despite increasing focus on safety in healthcare, there is still some way to go to make healthcare delivery safer. It is reported that approximately one in 20 patients experience preventable harm when receiving healthcare (Panagioti et al, 2019). One means of improving the safety of healthcare is developing the non-technical skills of healthcare professionals and equipping them with the knowledge and ability to manage the complex system within which they work.  

It has been estimated that only 25% of the important events which occur during a procedure are related to manual or technical skills and that 75% relate to human factors such as decision making, communication, teamwork and leadership (Kohn et al, 1999).  Other factors which are important in medicine include self-awareness (i.e., insight), conflict resolution and error management.   

While some individuals seem to have innate interpersonal and personal skills, many others can have these skills improved by formal education and training.  Although it is unlikely that innate personality can be changed, it is undoubtedly possible to alter certain aspects of behaviour which impact negatively on colleagues and on the team in the workplace.   

With appropriate training, individuals can improve their personal and interpersonal skills and thus function more effectively as part of the multidisciplinary team in which all doctors work today (Buljac-Samardzic et al, 2020; McCulloch et al, 2009; Cahan et al, 2010; Ounounou et al, 2019). The Human Factors in Patient Safety Training programme at RCSI aims to develop these skills in trainees through a mix of didactic teaching and action-based learning. 

Human Factors in Patient Safety Training – RCSI  

A programme of professional training in Human Factors in Patient Safety (HFPS) principles is a mandatory component of training for Surgical Trainees commencing at Core Training and continuing up to the final year of their Specialty Training Programmes. Trained faculty members and adjunct consultant trainers deliver the programme at No. 26 RCSI.  

The RCSI Human Factors in Patient Safety programme also has a unique focus on non-technical skills, such as communication, teamwork, decision-making, leadership and managing stress emphasising how these skills facilitate better performance and enhanced self-care. 

Human Factors Simulation Year ST3- ST6   

MASCOT1: Leading Teams: Multidisciplinary crisis resource management simulation training in the operating theatre 

MASCOT 2: Managing Teams: Multidisciplinary crisis resource management, simulation training in the emergency department 

Decision-making: Understanding decision strategies, biases and heuristics in decision-making, situation awareness 

Managing Adverse Events: Recovery from error, disclosure, Critical Incident investigations 

What is MASCOT Training 

A collaborate module of simulation training with the College of Anaesthetists (CAI) for multidisciplinary simulation training in the Mock OR and Emergency room for SpRs in Surgery, Emergency Medicine and Anaesthesia. It aims to develop skills to effectively manage an interdisciplinary team in the context of an acute clinical event, to develop good communication strategies in the context of acute events and to reinforce the trainees’ understanding of the role of good teamwork and communication in effectively managing the team and the clinical task. 

Specialty trainees are expected to attend class room based HFPS class over the course of their training in additional to simulation training. Some specialties will run bespoke  SpR SIMULATION DAYs for their own trainees each year these classes will be held in RCSI No 26. 

SpR Trainees (in relevant specialties) must attend 1 simulation and 1 classroom based HFPS day each year. Completing 2 days per year over 4 years. In ST7 & ST8 they must complete Cycle1 and Cycle 2. 

Trainees will be informed of the classes they need to attend each year and are asked to book their class via our online booking system. 

The Surgical Training office sends out a communication to all trainees when the relevant training calendar is available, normally August each year to book their classes.  

HFPS Specialty Training Modules