The Patient Safety Curriculum for Undergraduate Medical Students as a First Step Toward Improving Patient Safety

Objective

Despite the growing emphasis on patient safety and the need for patient safety education, few schools have included this subject in their curriculum. Medical students need to understand and demonstrate appropriate patient safety skills early and continuously in their professional education. Therefore, we introduced a week of patient safety curriculum as a pilot program and attempted to describe and evaluate the effectiveness of a patient safety curriculum for second-year medical students.

Design, Setting, Participants

A 1-week patient safety course was developed and taught to all second-year medical students as part of an existing patient–doctor society course. The curriculum was composed of interactive lecture, discussion, and small-group debriefing facilitated by a tutor dealing with topics about patient safety. Students were asked to complete questionnaires on awareness about patient safety before and after the curriculum.

Results

The comparison of questionnaire data obtained before and after the curriculum revealed that the students' awareness about patient safety was significantly increased. Among them, awareness of the frequency of medical errors made by physicians and the awareness of the adverse outcomes due to medical errors were remarkably changed.

Conclusions

These findings suggest that a patient safety course could increase the medical students' awareness of patient safety and the reality of medical errors. Continued development and implementation of patient safety curriculum will make medical students, as future doctors and health-care leaders, prepared to better practice and offer safer health care services than ever.

Introduction

Medical errors and patient safety have emerged as global concerns in the provision of quality health care. The 1999 Institute of Medicine (IOM) report, To Err Is Human: Building a Safer Health System, raised these concerns with its estimate of up to 98,000 annual deaths from medical errors in the United States. This report has alerted policy makers, hospitals, healthcare personnel, and patients with the major problems regarding patient safety.¹

Reducing harm caused by health care is a global priority, and there has been a dramatic increase in patient safety improvement efforts over the past decade with the development of science of patient safety.2, 3, 4, 5 Harm to patients is not inevitable and can be avoided. Clinicians and institutions must learn from past errors, and learn how to prevent future errors.

However, health care delivery continues to be potentially unsafe in certain situations despite erstwhile efforts.6, 7, 8 Experts in patient safety concluded that major medical education reforms at the medical school and residency training program levels are essential for substantive improvements in patient safety.9, 10, 11, 12, 13

Despite the significance of patient safety and the recognized need for patient safety education, few schools deal with this subject in their curriculum. Traditionally, curricula for doctors and medical students have focused on pure clinical skills, such as diagnosis of illness, treatment of disease, after-care, and follow-up. However, systems thinking, root cause analysis, and application of human factor science and communication skills have been largely overlooked. These skills are fundamental to patient safety, and all undergraduate medical students should have the necessary competence to minimize harm to patients.6, 14, 15, 16, 17 Incorporating the knowledge and skills of patient safety into the medical student curriculum is an urgent necessity. In this study, we describe and evaluate the effectiveness of a novel patient safety curriculum for second-year medical students at Seoul National University College of Medicine.