Patient safety: helping medical students understand error in healthcare

Abstract

Objective: To change the culture of healthcare organisations and improve patient safety, new professionals need to be taught about adverse events and how to trap and mitigate against errors. A literature review did not reveal any patient safety courses in the core undergraduate medical curriculum. Therefore a new module was designed and piloted. Design: A 5-h evidence-based module on understanding error in healthcare was designed with a preliminary evaluation using self-report questionnaires. Setting: A UK medical school. Participants: 110 final year students. Measurements and main results: Participants completed two questionnaires: the first questionnaire was designed to measure students' self-ratings of knowledge, attitudes and behaviour in relation to patient safety and medical error, and was administered before and approximately 1 year after the module; the second formative questionnaire on the teaching process and how it could be improved was administered after completion of the module. Conclusions: Before attending the module, the students reported they had little understanding of patient safety matters. One year later, only knowledge and the perceived personal control over safety had improved. The students rated the teaching process highly and found the module valuable. Longitudinal follow-up is required to provide more information on the lasting impact of the module.

Introducing patient safety to undergraduate medical students – A pilot program delivered by health care administrators

“…Reported studies, however, have identified deficiencies in patient safety training, and an explicit curriculum on patient safety is only available at a limited number of medical schools (Fulton 2004;Madigosky et al 2006;Patey et al 2007;Newell et al 2008;Alper et al 2009;Flin et al 2009). The implementation of patient safety teaching can be challenging.…”

“…Our brief programs have failed to promote a healthy reporting culture amongst our students, and they continued to rate their knowledge in patient safety as 'fair' or 'poor' only. These are important areas for improvement and it is likely that a more comprehensive and longitudinal program is needed (Fischer et al 2006;Patey et al 2007;Pearson et al 2010). We have since introduced patient safety in other clinical years in order to ensure the maintenance of new knowledge.…”

“…Both brief (Halbach & Sullivan 2005;Patey et al 2007) and extended (Mayer et al 2009) curricula on patient safety have been described, and the formats may vary from the use of team-based patient safety events (Anderson et al 2009) to video-assisted simulation (Flanagan et al 2004;Mayer et al 2009). Improvement in students' knowledge and awareness has been reported although not all positive changes were sustained (Halbach & Sullivan 2005;Madigosky et al 2006).…”

“…Medical incidents have become important educational resources in recent years and the introduction of patient safety into undergraduate medical education signifies a major change in culture (Halbach & Sullivan 2005;Patey et al 2007;Anderson et al 2009). Medical student teaching plays an important role in promoting the correct concepts and skills in patient safety but there is as yet no consensus on how the subject should be taught (Flanagan et al 2004;Fischer et al 2006).…”

Attitudes to patient safety amongst medical students and tutors: Developing a reliable and valid measure

“…Some attempts have been made to evaluate patient safety education. For example, Patey et al (2007) evaluated the development of a new patient safety module for medical students in the UK and, although the attitude measure they used to evaluate the success of the new module was theoretically derived, it was not validated. Muller and Ornstein (2007) also measured attitudes of medical trainees, including medical students, this time focussing on the perceived consequences of making a medical error with more or less serious outcomes.…”