How Do Simulated Error Experiences Impact Attitudes Related to Error Prevention?

Abstract

Introduction: The objective of this project was to determine whether simulated exposure to error situations changes attitudes in a way that may have a positive impact on error prevention behaviors.

Methods: Using a stratified quasi-randomized experiment design, we compared risk perception attitudes of a control group of nursing students who received standard error education (reviewed medication error content and watched movies about error experiences) to an experimental group of students who reviewed medication error content and participated in simulated error experiences. Dependent measures included perceived memorability of the educational experience, perceived frequency of errors, and perceived caution with respect to preventing errors.

Results: Experienced nursing students perceived the simulated error experiences to be more memorable than movies. Less experienced students perceived both simulated error experiences and movies to be highly memorable. After the intervention, compared with movie participants, simulation participants believed errors occurred more frequently. Both types of education increased the participants' intentions to be more cautious and reported caution remained higher than baseline for medication errors 6 months after the intervention.

Conclusions: This study provides limited evidence of an advantage of simulation over watching movies describing actual errors with respect to manipulating attitudes related to error prevention. Both interventions resulted in long-term impacts on perceived caution in medication administration. Simulated error experiences made participants more aware of how easily errors can occur, and the movie education made participants more aware of the devastating consequences of errors.

FIGURE 1.

Mean responses to questions regarding perceived memorability of simulation and movie interventions by trainee experience level. *Significantly different at P < 0.005.

FIGURE 2.

Mean responses to questions regarding the perceived frequency of 3 different types of errors over time. Sim, simulation. *Significantly different than pretest scores, P < 0.01. Error bar displays standard error.

FIGURE 3.

Mean responses to perceived caution in nursing activities related to 3 different types of AEs over time. Sim, simulation. *Significantly different than pretest, P < 0.01. Error bar displays standard error.