Analysis and Safety Management of Incidents in Post-graduate Clinical Training

Abstract

 Abstract The aim of this study was to promote safe clinical training by analyzing the incidents reported by trainee dentists at the General Dentistry and Clinical Education Unit, Niigata University Medical and Dental Hospital. Incident reports submitted by trainee dentists from April 2006 to March 2014 were examined. The number, type, patient effect, background and incidence of the incidents were analyzed. A total of 77 incidents were reported by trainee dentists during the 9 years ; 71 were attributed to trainee dentists, and 6 were attributed to trainee dentists and students or instructors together. Fifty-five incidents occurred when trainee dentists were treating patients in a dental practice. The most frequently occurring incidents (26 cases) were soft tissue injuries caused by burs or points powered by an air turbine or motor engine, or a heated instrument. These incidents rated a patient effect level of “3a”. The background of the incidents was related to deficiencies in technical skills, check skills, observational skills, decision-making skills, and knowledge. The number of incidents was calculated as 0.1-0.6 per trainee dentist per year. The incidence was calculated as 0.03-0.43% per dental practice accepting trainee dentists. The frequency of incidents decreased gradually over the study period, suggesting that continuation and improvement of safety management, such as incident reporting and KYT training (hazard prediction activities), are important factors in the future prevention of incidents in post-graduate clinical training.