Table 1

Examples of student’s recommendations categorised by strength for the academic year 2015–2016 at Wayne State University, School of Medicine using qualitative data analysis

Strength of the recommendation		Recommendation
Stronger	Standardisation of process	‘Reviewing of an X-ray could be standardised’.
Stronger	Simplifying process	‘Requesting new syringes with the appropriate measuring and needle combination to be available for (insulin) use so the transfer of insulin to an additional syringe (is) eliminated from the delivery process’.
Intermediate	Enhance communication	‘It is essential that there is proper written and verbal sign out of every patient. There should be a component of teach back between the new team taking over care and the team leaving for the evening’.
	Cogitative aid	‘Patient should have a Do Not Resuscitate (DNR) wristband that can be clearly seen’.
	Software enhancement	‘Have a warning/notification in the electronic medical record that prompts a physician completing discharge documentation that there are still blood culture results pending’.
	Checklists	‘Having a checklist to make sure each of the precautions have been addressed’.
	Staffing	‘Ensure that that there (are) an appropriate number of nurses staffed, otherwise nurses will feel pressured to rush their work’.
Weaker	Warning labels	‘Put contact precaution sign on the door’.
	Double checks	‘The order should be checked and double checked. The resident should be more careful when making orders’.
	Training and policy	‘A policy could be implemented that requires all personnel changing or inserting PICC lines to have completed a training session every 6 months… (otherwise) the PICC line (insertion) must be under the direct supervision of someone more experienced’.

PICC, peripherally inserted central catheter.