Impact of Patient Safety Mandates on Medical Education in the United States

Abstract

Purpose: To determine the impact of the Institute of Medicine recommendations regarding patient safety on medical education resources in the United States. Methods: Medical textbooks representing major disciplines of medicine in the United States were surveyed for patient safety-related keywords, and content presented was quantified. Allopathic medical school curricula in the United States were reviewed for required or elective patient safety coursework using an on-line database, and specific curricula details were described. The Accreditation Council for Graduate Medical Education Residency Review Committee program requirements for accreditation were reviewed, and patient safety content was quantified. Results: Fifteen (54%) of the most recently published textbook editions reviewed contained patient safety information, and 11 of those (73%) specifically cited the Institute of Medicine report. Of the latest edition textbooks with safety keywords present, 67% dedicated entire chapters to patient safety or quality improvement. In 2007 and 2008, 10.4% of the 125 U.S. medical schools reported patient safety content in elective or required courses. All of the Accreditation Council for Graduate Medical Education Residency Review Committee program requirements contained patient safety content confined to systems-based practice and work-hour restrictions. Conclusions: Popular medical textbook content and core medical school and graduate medical education curricula do not adequately reflect the directive to increase patient safety education and reduce medical error.