• Simran Jawanda

QI Training from a Medical Student Perspective

We are delighted to feature Mitch Hutchinson's blog post reflecting on his progress through the IHI Open School Basic Certificate in Quality and Safety. Mitch is a medical student in the Northern Medical Program in Prince George.

I am a medical student in a small northern British Columbia city where I was born and raised and like many other medical students, I have a relatively diverse background. I worked various odd jobs throughout my undergraduate studies, ranging from Power Engineer at a local pulp mill to personal trainer at the university fitness centre, and through these jobs I have been exposed to many different types of systems and processes. Working for both small companies and large corporations I have seen different perspectives on safety and the culture that surrounds it. A couple of years ago I started the Registered Nursing program and became exposed to the hospital setting and was fortunate to interact with many patients prior to my acceptance into the medical program at UBC. My diverse exposure coupled with my natural curiosity around programming and system functioning inspired the development of my own research looking at our Northern Medical Program with a focus on physician retention after training. Fortuitously for me, this led me to the IHI Open School Basic Certificate in Quality and Safety.

I started this program like many people start online modules, slowly slogging away at the first couple lessons to try and save that certificate file for a future upload. Very shortly after (maybe 1 or 2 modules in) I started to become extremely captivated by things I was learning. Throughout my life I have seen different perspectives on safety culture, and one commonality between what I have observed and what this certificate teaches is that punitive repercussion are NOT effective in developing a culture of safety in the workplace. When we fear repercussions for minor mistakes, job satisfaction plummets and burnout skyrockets, feeding into a dangerous cycle of complacency. I have observed medical errors happen in my nursing practical curriculum where students stayed silent due to fear of consequences. When students felt they could come forward, talk about it, learn from it, and perhaps contribute to fixing the system that allowed the errors to take place, there was zero hesitation in coming forward. As this certificate attests, we must have a healthy culture of safety in health care so that when errors do happen they can hopefully be rectified and prevented from happening again.

Another thing that I found valuable from this program was the entire portion on statistics and modelling of processes. This also included types of errors (i.e. latent, active, etc.) and how we can look at a system and narrow in on specifics of what went wrong. I have always been one of those employees that cannot stay quiet when I see things operating less than ideally, yet I had never been exposed to this type of education before. Now, where I used to be that annoying employee trying to tell managers what I think the right way to do things is, perhaps I can come forward with a more tactful approach. I truly feel confident that I have a more thorough, evidence based grasp on analyzing the setting, determining what and where things went wrong, localizing it to a system or a human approach, understanding shortcomings of technology in practice, and many other factors in trying to make a system more effective and safe, rather than just having a gut feeling that things were not right.

It is easy for those of us with busy lifestyles (medical, nursing, pharmacy, dentistry, etc.) and many academic years under us to only spend our time on things that add accolades to our C.V.s for future use, however, this program not only does that but provides invaluable knowledge to boost our awareness of how systems can be designed, not to fail, but with some inherent flaws that we can identify with the proper perspectives. I plan to continue doing these modules even though they no longer factor into any school related credential, but because I feel that I will be a better physician in the future with the knowledge that I have attained.

- Mitch Hutchison, MD Candidate 2022

If you are interested in completing the IHI Open School Basic Certificate in Quality and Safety, please visit IHI Open School.