We hypothesized that a multifaceted, learner-centered diabetes curriculum would help reduce pathway errors.
For three of the five categories of pathway errors, there was a decrease in total number of resident errors.
embedded subtle errors into the case, reflecting the five main categories of documented pathway errors (insulin, communication, intravenous fluids, nutrition, and discharge delay).
On the basis of previously occurring pathway errors, we hypothesized that nearly all errors would fall into one of five areas: insulin, communication, intravenous fluids, nutrition, and discharge delay.
During this 1-h noon conference, residents were divided into four teams and were instructed to uncover and categorize each of the pathway errors, offer immediate solutions to the patient's current status, and project how they might prevent the same errors from occurring again.
The 8-week curricular intervention consisted of 1) an online tutorial addressing residents' baseline diabetes management knowledge, 2) an interactive diabetes pathway discussion, 3) a learner-initiated diabetes question and answer session, and 4) a case presentation featuring embedded pathway errors for residents to recognize, resolve, and prevent.
Both branches of this pathway are error free.
For example, when wild-type Pol ε misinserts a nucleotide, the major pathway of error avoidance is exonucleolytic proofreading, whereas the mutation is generated if the mismatch is extended (central arrow).
In order to illustrate the pathway between errors and preventable adverse events, we will model expected reductions in adverse events from (any) reductions in error rates.
Little is known about the molecular details of PRR, but genetic studies have revealed an intricate system of several independent pathways, comprising error-free and error-prone sub-pathways that allow the bypass of replication-blocking lesions [54].
