PATIENT SAFETY TRAINING WITH THE REVERSE FACE TRAINING MODEL

Study Overview
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Brief Summary
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Patient safety is one of the indispensable parts of nursing education (22). Educating future healthcare professionals about patient safety is very important in terms of providing safe and quality service (23). In order to include patient safety in the education of nursing students and to determine the effectiveness of the education given, it is necessary to regularly evaluate their knowledge, skills and attitudes about patient safety (22). At this point, this study was planned in order to increase the awareness of senior nursing students about patient safety before graduation, to evaluate their knowledge, skills and attitudes, to improve the quality of patient care after graduation, and to help minimize or eliminate the possibility of making medical errors. The aim of this study is to examine the effect of the flipped education model on the patient safety competencies of nursing students and their satisfaction with the education method.

Detailed Description
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The World Health Organization (WHO) defines patient safety as the absence of preventable harm in the health care process and minimizing the unnecessary risks associated with health care service (1). In addition, patient safety is the primary and indispensable condition of quality and qualified health services, and it refers to the avoidance of medical errors at every stage of health care by health institutions and employees in the institution and all the precautions taken in order to prevent the harm that health care services may cause to individuals (2). However, WHO reports that patients encounter many harmful situations while receiving health care services (3). It has been reported that one out of every ten patients suffers serious damage due to medical errors, and around ten million people are disabled or even lost their lives due to preventable malpractices worldwide every year (4). It is stated that the most common medical errors are related to drug administration, misuse of equipment and biological accidents (5). In studies conducted in the United States, it is emphasized that the number of deaths due to medical errors is higher than the number of deaths from traffic accidents, breast cancer or AIDS, and it is stated that medical errors that directly affect patient safety are ranked fifth among the causes of death (4). In Turkey, it has been reported that official records on patient safety are available to a limited extent, although many people die or become disabled due to medical errors each year (6). This situation further reveals the importance of the concept of patient safety (7). Nurses, who serve their patients 24/7 in hospitals, work actively in all areas, can make quick decisions and think critically, have a key role in ensuring and maintaining patient safety (5). In order to actively ensure patient safety, nurses need to develop their knowledge, attitudes, skills and competencies regarding patient safety. At this point, the education that nurses have received since their student years is of great importance (8). During their education, student nurses are tried to gain theoretical and psychomotor skills with a traditional approach in classrooms, laboratory environments and clinics (9). However, due to the increasing number of students, lack of laboratory conditions, time constraints, and lack of teaching staff, the development of knowledge and skills of nursing students may be insufficient. Students who go to clinical practice before the desired level of knowledge and skill development is completed may encounter the situation of making medical mistakes for the first time, as they experience the anxiety of intervening with the real patient other than the model/mannequin, and also the anxiety of taking notes (10). In addition, they may witness medical malpractices during clinical practices (11). In the face of these situations that threaten patient safety, it is recommended that different education and training techniques should be applied in order for students to gain the correct knowledge, skills and attitudes, namely competency regarding patient safety (11). Because today, traditional learning methods are no longer sufficient to attract the attention of students (12). For this reason, in recent years, the flipped education model has been used together with the traditional education model in nursing education. The flipped education model is a model that covers different teaching methods and is effective on the academic success of students. (13). Flipped education model; It is an innovative learning model blended as information and technology, supported by pre-class and in-class activities (14).In the flipped education model, the instructor shares the educational materials such as presentations and videos that he has prepared before the lesson with the student, and the students are required to come to the lesson by studying. It enables students to improve their knowledge and skills through activities such as group discussions, case presentations, and brainstorming (15). In the flipped education model, the instructor prepares the educational materials in line with the needs of the student, and in this education model, the student can study the educational materials personally at any time and place in a flexible time frame before coming to the lesson. In the flipped education model, the student actively participates in the lesson by using learning methods, while the instructor acts as a consultant and differs from the traditional learning model in these aspects (16). When the studies on the flipped education model and patient safety competency are examined in the literature; Kim et al. (2019) reported a significant increase in patient safety competency between pretest and posttest results in the study titled The effects of a patient safety course using the flipped classroom approach among nursing undergraduate students: A quasi-experimental study. In other words, they stated that flipped education increases the patient safety knowledge, skills and attitudes of nursing students (17). Cho et al (2022) reported that simultaneous online patient safety education improved the knowledge and skills of nursing students in their study titled The effect of online education on knowledge, attitudes and skills of nursing students in Korea: a mixed method study (18). Torkaman et al. (2022) reported that patient safety education is partially effective in improving the patient safety competencies of nursing students in their study titled The Effect of Patient Safety Education on the Patient Safety Competencies of Nursing Undergraduate Students(19). Fırat Kılıç and Cevheroğlu (2023), in their study titled Patient Safety Competencies of Nursing Students, reported that the knowledge, skills and attitudes of nursing students on patient safety were satisfactory and that the students got the lowest score from the patient safety competency scale in the knowledge sub-dimension (20). Huang et al. (2020) in their study Self-reported confidence in patient safety competencies among Chinese nursing students: a multisite cross-sectional survey stated that fourth-year nursing students had moderate patient safety competencies (21). In conclusion, patient safety is one of the indispensable parts of nursing education (22). Educating future healthcare professionals about patient safety is very important in terms of providing safe and quality service (23). In order to include patient safety in the education of nursing students and to determine the effectiveness of the education given, it is necessary to regularly evaluate their knowledge, skills and attitudes about patient safety (22). At this point, this study was planned in order to increase the awareness of senior nursing students about patient safety before graduation, to evaluate their knowledge, skills and attitudes, to improve the quality of patient care after graduation, and to help minimize or eliminate the possibility of making medical errors. The aim of this study is to examine the effect of the flipped education model on the patient safety competencies of nursing students and their satisfaction with the education method.

Official Title
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The Effect of Flipped Education Model on Nursing Students' Patient Safety Competencies and Satisfaction With Education Method: A Randomized Controlled Study

Conditions
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Nursing Student, Flipped Education Model

Intervention / Treatment
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* Other: patient safety competency
* Other: satisfaction with the training method


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Being a 4th year student at Eastern Mediterranean University, Faculty of Health Sciences, Department of Nursing Volunteering to participate in the study, Studying in the Turkish department Exclusion Criteria: -
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Crossover Assignment
Interventional Model Description: randomized controlled trial
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Flipped Educational Model<br>Giving the subject of patient safety education with the flipped education model | Other: patient safety competency<br>* Investigation of the effect of patient safety education given with the flipped education model and traditional education model on the competence levels of the students.<br>Other: satisfaction with the training method<br>* Investigation of the effect of patient safety education given with the flipped education model and traditional education model on the satisfaction levels of the students from the education methods.<br>|
| Active Comparator: Traditional Educatıonal Model<br>Giving the subject of patient safety education with the traditional education model | Other: patient safety competency<br>* Investigation of the effect of patient safety education given with the flipped education model and traditional education model on the competence levels of the students.<br>Other: satisfaction with the training method<br>* Investigation of the effect of patient safety education given with the flipped education model and traditional education model on the satisfaction levels of the students from the education methods.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The effect of patient safety training given with the flipped training model on patient safety competence | Patient safety competence scale will be used before and after patient safety training, which will be given with flipped training. | 6 weeks | 
| The effect of the patient safety training given with the flipped training model on the level of satisfaction | After the patient safety training, which will be given with the flipped training model, a satisfaction survey will be used from the training method. | 6 weeks | 
| The effect of patient safety education given with the traditional education model on patient safety competence | The patient safety competence scale will be used before and after the patient safety training, which will be given with the traditional training model. | 6 weeks | 
| The effect of patient safety education given with the traditional education model on the level of satisfaction | A satisfaction survey will be used from the training method after the patient safety training, which will be given with the traditional training model. | 6 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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nursing student,, patient safety,, flipped education model,, nursing education