SEA change – the use of significant event analysis in primary care teaching

Figures & data

Figure 1. Significant event analysis for education ‘SEAFE’ proforma.

Table 1. An example SEAFE relating to a teaching session.

A student was triggered by a teaching session around domestic violence & sexual abuse (DV&SA). When investigated, it was found that there had been inadequate forewarning of the session’s contents and signposting to student support within the teaching materials. A SEAFE was conducted and discussed. The outcome of the SEAFE was that future students would receive more advanced warning of forthcoming DV&SA teaching and be explicitly signposted to support. The content of this particular session was also modified. Furthermore, the SEAFE was shared with the DV&SA research group within the University who have, as a result, founded a student advisory board which now helps to shape and review DV&SA teaching materials before they are delivered.

Table 2. An example SEAFE relating to a organisation issue.

A practice due to take 6 third year students pulled out of teaching the night before it was due to start as a sudden staffing crisis occurred, brought about by a COVID-19 outbreak within the surgery. As the teaching was being delivered online it was possible to allocate all of these students to alternative practices at short notice. However, it highlighted an issue which could easily occur again in any year group and would be a particular problem if teaching were face to face. A SEAFE was raised and discussed. It was concluded that each year group lead should ‘stress test’ their course to ensure that they would be able to cope with a practice (or practices) dropping out at short notice. It was also agreed that in future recruitment rounds during the pandemic each year group would aim to run at a surplus of places so that students could easily be placed if this were to occur again.

Table 3. Frequency of SEAFE topics during this pilot.

Topic	Number of SEAFEs
Data Protection	6
Administrative	4
Unconscious bias	4
COVID-19	2
Other	3

Table 4. Summary of learning points.

When designing your own SEAFE proforma keep it simple and align it closely with existing clinical SEA proformas to ensure ease of completion. Take time to train non-clinical staff in the process; they may be less familiar with SEA. Try to ensure a supportive environment which encourages the raising of SEAFEs as a learning tool rather than for apportioning blame Encourage staff to raise ‘positive’ SEAFEs when things go well When conducting a SEAFE review meeting ensure ground rules are set and try to conduct these in person (rather than online) where possible.