Exploring nursing students' patient safety learning experiences during clinical practice: A qualitative study utilizing the SLERT tool

Background: Patient safety is a global concern. Practice-based nursing education is pivotal in fostering safety knowledge, skills, and practice. The ‘SLIPPS’ Learning Event Recording Tool (SLERT), available in multiple European languages, was developed to aid healthcare students document, reflect on, and learn from, real patient-safety events. It is important to explore SLERT translation and use in diverse cultural and healthcare contexts, and in widely spoken languages such as Persian.

Objectives: To translate the SLERT into Persian and investigate Iranian nursing students' use of the tool to reflect on patient safety related events experienced during clinical practice.

Design: SLERT adaption followed by a 2-stage qualitative descriptive study.

Settings: Ardabil in northwest Iran.
Participants: Nursing students (n=63) recruited through purposeful sampling.
Methods: Data were collected through accompanied completion of an electronic or paper version of the SLERT. Participants were prompted to express thoughts and reflections aloud in a storytelling manner (stage 1). Qualitative content analysis was used, during which follow-up interviews helped clarify ambiguities (stage 2).

Results: Twenty-three electronic and 40 paper SLERT reports were completed. Students reported 8 near-misses, 7 hazards, 10 adverse-events, and 38 good-practice episodes. A core theme "Enhanced Learning from Events" was developed comprising four main-categories: Consideration of event classification (severity/topic), Recognition of event outcomes (negative event outcomes and positive learning); Identification of possible causes and solutions (individual/organizational factors); Identification of factors influencing learning (impact of environment, educator & educational approaches).

Conclusion: Participants in this study found the SLERT a useful tool in promoting and supporting reflection on real patient safety events. An original finding regards how SLERT use had the inadvertent benefit of promoting learning about event classification. Students went beyond reflecting solely on the antecedents and outcomes of the event, to consider how events are classified and to analyze their own learning experiences and outcomes.