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Tay KT, Tan XH, Tan LHE, Vythilingam D, Chin AMC, Loh V, Toh YP, Krishna LKR. A systematic scoping review and thematic analysis of interprofessional mentoring in medicine from 2000 to 2019. J Interprof Care 2020; 35:927-939. [PMID: 33290115 DOI: 10.1080/13561820.2020.1818700] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Interprofessional mentoring in palliative care sees different members of the interprofessional team providing holistic, personalised andlongitudinal mentoring support, skills training and knowledge transfer as they mentor trainees at different points along their mentoring journeys. However, gaps in practice and their risk of potential mentoring malpractice even as interprofessional mentoring use continues to grow in palliative medicine underlines the need for careful scrutiny of its characteristics and constituents in order to enhance the design, evaluation and oversight of interprofessional mentoring programmes. Hence, a systematic scoping review on prevailing accounts of interprofessional mentoring in medicine is conducted to address this gap. Using Arksey and O'Malley's (2005) methodological framework for conducting scoping reviews and identical search strategies, 6 reviewers performed independent literature reviews of accounts of interprofessional mentoring published in 10 databases. Braun and Clarke's (2006) thematic analysis approach was adopted to evaluate across different mentoring settings. A total of 11111 abstracts were identified from 10 databases, 103 full-text articles reviewed and 14 full-text articles were thematically analysed to reveal 4 themes: characterizing, implementing, evaluating and obstacles to interprofessional mentoring. Interprofessional mentoring is founded upon a respectful and collaborative mentoring relationship that thrives despite inevitable differences in individual values, ethical perspectives at different career stages within diverse working environments. This warrants effective mentor-mentee trainings, alignment of expectations, roles and responsibilities, goals and timelines, and effective oversight of the programmes. Drawing upon the data provided, an interprofessional mentoring framework is forwarded to guide the design, evaluation and oversight of the programmes.
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Affiliation(s)
- Kuang Teck Tay
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Xiu Hui Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lorraine Hui En Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Divya Vythilingam
- School of Medicine, International Medical University Malaysia, Kuala Lumpur, Malaysia
| | - Annelissa Mien Chew Chin
- Medical Library, National University of Singapore Libraries, National University of Singapore, Singapore
| | - Victor Loh
- Department of Family Medicine, National University Health System, Singapore
| | - Ying Pin Toh
- Department of Family Medicine, National University Health System, Singapore.,Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore.,Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, Liverpool, UK.,Centre for Biomedical Ethics, National University of Singapore, Singapore.,Duke-NUS Graduate Medical School, Singapore
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Lee FQH, Chua WJ, Cheong CWS, Tay KT, Hian EKY, Chin AMC, Toh YP, Mason S, Krishna LKR. A Systematic Scoping Review of Ethical Issues in Mentoring in Surgery. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2019; 6:2382120519888915. [PMID: 31903425 PMCID: PMC6923696 DOI: 10.1177/2382120519888915] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 10/21/2019] [Indexed: 05/03/2023]
Abstract
BACKGROUND Mentoring is crucial to the growth and development of mentors, mentees, and host organisations. Yet, the process of mentoring in surgery is poorly understood and increasingly mired in ethical concerns that compromise the quality of mentorship and prevent mentors, mentees, and host organisations from maximising its full potential. A systematic scoping review was undertaken to map the ethical issues in surgical mentoring to enhance understanding, assessment, and guidance on ethical conduct. METHODS Arksey and O'Malley's methodological framework was used to guide a systematic scoping review involving articles published between January 1, 2000 and December 31, 2018 in PubMed, Embase, Scopus, ERIC, ScienceDirect, Mednar, and OpenGrey databases. Braun and Clarke's thematic analysis approach was adopted to compare ethical issues in surgical mentoring across different settings, mentee and mentor populations, and host organisations. RESULTS A total of 3849 abstracts were identified, 464 full-text articles were retrieved, and 50 articles were included. The 3 themes concerned ethical lapses at the levels of mentor or mentee, mentoring relationships, and host organisation. CONCLUSIONS Mentoring abuse in surgery involves lapses in conduct, understanding of roles and responsibilities, poor alignment of expectations, and a lack of clear standards of practice. It is only with better structuring of mentoring processes and effective support of host organisation tasked with providing timely, longitudinal, and holistic assessment and oversight will surgical mentoring overcome prevailing ethical concerns surrounding it.
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Affiliation(s)
- Fion Qian Hui Lee
- Yong Loo Lin School of Medicine,
National University of Singapore, Singapore
| | - Wen Jie Chua
- Yong Loo Lin School of Medicine,
National University of Singapore, Singapore
| | - Clarissa Wei Shuen Cheong
- Yong Loo Lin School of Medicine,
National University of Singapore, Singapore
- Division of Supportive and Palliative
Care, National Cancer Centre Singapore, Singapore
| | - Kuang Teck Tay
- Yong Loo Lin School of Medicine,
National University of Singapore, Singapore
| | | | - Annelissa Mien Chew Chin
- The Medical Library at the Yong Loo Lin
School of Medicine, National University of Singapore, Singapore
| | - Ying Pin Toh
- Department of Family Medicine, National
University Hospital Singapore, Singapore
| | - Stephen Mason
- Marie Curie Palliative Care Institute,
University of Liverpool, Liverpool, UK
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine,
National University of Singapore, Singapore
- Division of Supportive and Palliative
Care, National Cancer Centre Singapore, Singapore
- Marie Curie Palliative Care Institute,
University of Liverpool, Liverpool, UK
- Centre of Biomedical Ethics, National
University of Singapore, Singapore
- Duke-NUS Medical School, National
University of Singapore, Singapore
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Bolsin S, Pal R, Wilmshurst P, Pena M. Whistleblowing and patient safety: the patient's or the profession's interests at stake? J R Soc Med 2011; 104:278-82. [PMID: 21725092 PMCID: PMC3128871 DOI: 10.1258/jrsm.2011.110034] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Stephen Bolsin
- Department of Clinical & Biomedical Sciences, The Geelong Hospital, Australia.
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Hornsey MJ, Frederiks E, Smith JR, Ford L. Strategic defensiveness: Public and private responses to group criticism. BRITISH JOURNAL OF SOCIAL PSYCHOLOGY 2010; 46:697-716. [DOI: 10.1348/014466606x170315] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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KUMAR MALHARN. Dealing with Misconduct in Biomedical Research: A Review of the Problems and the Proposed Methods for Improvement. Account Res 2009; 16:307-30. [DOI: 10.1080/08989620903328576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- MALHAR N. KUMAR
- a Consultant Orthopedic Surgeon, HOSMAT Hospital , Bangalore , India
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Freestone L, Bolsin SN, Colson M, Patrick A, Creati B. Voluntary incident reporting by anaesthetic trainees in an Australian hospital. Int J Qual Health Care 2006; 18:452-7. [PMID: 17052992 DOI: 10.1093/intqhc/mzl054] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To assess the reporting of critical incidents by anaesthetic trainees using personal digital assistants. The project also identified the reporting of 'near miss' incidents by anaesthetic trainees. DESIGN Comparison of electronic incident reporting with retrospective case note review of cases in which no incident was reported. SETTING A 400-bed university teaching hospital in Victoria. PARTICIPANTS Fourteen accredited Australian and New Zealand College of Anaesthetists (ANZCA) registrars and their training supervisors. INTERVENTIONS Registrars and supervisors underwent initial training for 1 hour and were provided with ongoing support. The cases and incidents reported to the database using the portable digital assistants were analysed. MAIN OUTCOME MEASURES These were the total number of anaesthetics reported to the database; the number of incidents reported to the database; the outcome severity of incidents reported; and the number of incidents detected in the case note review that were not reported to the database. RESULTS An incident was reported for 156 (3.5%) of 4441 anaesthetic procedures reported to the database. Of these incidents, 72 (46.2%) were 'near misses'. One incident was identified in a review of 208 case notes, which had no incidents reported electronically, and was not reported to the database electronically. This gives a reporting rate of 99.52% [95% confidence interval (CI) 96.9-100%]. CONCLUSIONS ANZCA trainees in routine anaesthetic practice can reliably use mobile computing technology to report critical incidents and 'near miss' incident data.
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Affiliation(s)
- Liadaine Freestone
- Department of Anaesthesia, The Geelong Hospital, Geelong, Victoria, Australia
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Crone KG, Muraski MB, Skeel JD, Love-Gregory L, Ladenson JH, Gronowski AM. Between a Rock and a Hard Place: Disclosing Medical Errors. Clin Chem 2006; 52:1809-14. [PMID: 16858069 DOI: 10.1373/clinchem.2006.072678] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackground: Healthcare-related errors cause patient morbidity and mortality. Despite fear of reprimand, laboratory personnel have a professional obligation to rapidly report major medical errors when they are identified. Well-defined protocols regarding how and when to disclose a suspected error by a colleague do not exist.Patient: We describe a woman with a well documented allergy to sulfamethoxazole who was treated with sulfadiazine that led to toxic epidermal necrolysis. After the patient’s death, the laboratory medicine resident was asked by one of the patient’s physicians to measure serum sulfadiazine, but only if the results were not reported in the patient’s electronic medical record. The case was brought to the attention of a laboratory medicine faculty member and the hospital risk management team.Issues: Laboratorians are patient fiduciaries and are responsible for reporting errors. Most medical associations have codes of ethics that address disclosure of incompetence and errors, although the AACC’s Guide to Ethics does not. New types of error, risk management, and root-cause analyses help to shift the focus to system errors and away from individuals’ errors. This can lead to a healthcare environment that encourages truth and disclosure rather than fear and reprimand.Disposition: The individuals involved in the presented case fulfilled their fiduciary duty to the patient by reporting this incident. An extensive investigation showed that, in fact, no medical errors or misconducts had occurred in the care of the patient.
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Affiliation(s)
- Kimberley G Crone
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
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Johnstone MJ, Kanitsaki O. The ethics and practical importance of defining, distinguishing and disclosing nursing errors: A discussion paper. Int J Nurs Stud 2006; 43:367-76. [PMID: 15979075 DOI: 10.1016/j.ijnurstu.2005.04.010] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2004] [Revised: 04/20/2005] [Accepted: 04/26/2005] [Indexed: 12/21/2022]
Abstract
Nurses globally are required and expected to report nursing errors. As is clearly demonstrated in the international literature, fulfilling this requirement is not, however, without risks. In this discussion paper, the notion of 'nursing error', the practical and moral importance of defining, distinguishing and disclosing nursing errors and how a distinct definition of 'nursing error' fits with the new 'system approach' to human-error management in health care are critiqued. Drawing on international literature and two key case exemplars from the USA and Australia, arguments are advanced to support the view that although it is 'right' for nurses to report nursing errors, it will be very difficult for them to do so unless a non-punitive approach to nursing-error management is adopted.
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Affiliation(s)
- Megan-Jane Johnstone
- Division of Nursing and Midwifery, School of Health Sciences, RMIT University, Plenty Road, Bundoora Vic 3083, Australia.
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Bolsin S, Patrick A, Colson M, Creatie B, Freestone L. New technology to enable personal monitoring and incident reporting can transform professional culture: the potential to favourably impact the future of health care. J Eval Clin Pract 2005; 11:499-506. [PMID: 16164592 DOI: 10.1111/j.1365-2753.2005.00567.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
There have been recent exposures of poor health care performance in many countries with western health care systems. The poor performance has either related to poor or criminal practices routinely going undetected or to organizational indifference or hostility to staff raising concerns about perceived poor standards of care. The demonstration that routine performance data monitoring would have detected and prevented many of the deaths attributed to poor surgical standards in the Bristol Royal Infirmary paediatric cardiac surgery scandal and criminal behaviour in the Harold Shipman scandal has highlighted the need for routine data collection to demonstrate to both health care administrators and patients that minimum standards of clinical practice are being achieved. The recent proposal that surgical report cards represent an important minimum ethical standard for health care consent will force the medical profession to engage in the debate surrounding routine data collection for performance monitoring and other purposes. This article considers the cultural background to data collection in the medical profession and the cost implications of failing to improve data collection in the areas of performance monitoring and incident reporting. A potential solution developed by the Geelong hospital group and in use in Australia is proposed as a novel, technologically appropriate and working example of practical data collection. This model is endorsed by the professional specialties and supported by modern regulatory theory. The individual, local and system wide benefits of such personal professional data collection are outlined and the necessary prerequisites are detailed.
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Affiliation(s)
- Stephen Bolsin
- Division of Perioperative Medicine, Anaesthesia & Pain Medicine, The Geelong Hospital, Geelong, Victoria, Australia.
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Hornsey MJ. Why being right is not enough: Predicting defensiveness in the face of group criticism. EUROPEAN REVIEW OF SOCIAL PSYCHOLOGY 2005. [DOI: 10.1080/10463280500436040] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Faunce TA, Bolsin SNC. Three Australian whistleblowing sagas: lessons for internal and external regulation. Med J Aust 2004. [DOI: 10.5694/j.1326-5377.2004.tb06160.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bolsin S, Patrick A, Creati B, Colson M, Freestone L. Electronic incident reporting and professional monitoring transforms culture. BMJ 2004; 329:51-2. [PMID: 15231631 PMCID: PMC443490 DOI: 10.1136/bmj.329.7456.51-b] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bolsin S, Solly R, Patrick A. The value of personal professional monitoring performance data and open disclosure policies in anaesthetic practice: a case report. Qual Saf Health Care 2003; 12:295-7. [PMID: 12897364 PMCID: PMC1743729 DOI: 10.1136/qhc.12.4.295] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A case is reported in which routine detailed trainee performance monitoring data collected as part of a personal professional monitoring programme were used to help justify to a patient and relatives the unforeseeable nature of a rare complication of a procedure. The data also supported the decision to allow the trainee to undertake the procedure. The personal professional monitoring programme conforms to the highest standards of clinical governance for trainees, consultants, departments, hospitals, and professional colleges. Data from the programme are fed back to the trainees and used to guide training requirements and to provide objective evidence of trainee assessments, practical ability, and competence.
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Affiliation(s)
- S Bolsin
- Department of Perioperative Medicine, Anaesthesia & Pain Management, The Geelong Hospital, Geelong, Victoria 3220, Australia.
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