Patient Safety Curriculum Research Articles

Teaching Strategies and Examples of Patient Safety Education in Nursing Students

The second National Patient Safety Comprehensive Plan was developed in 2023. In this, national-level patient safety education is designated as the fifth core task, with the establishment of an educational system for preliminary healthcare professionals included as a detailed task. The foundation for providing patient safety education to preliminary healthcare professionals has now been established. In 2011, the World Health Organization (WHO) published standard guidelines for patient safety education for healthcare professionals. This study introduces the WHO's 'Patient Safety Curriculum Guide: Multi-professional Edition' and shares the experiences and cases of patient safety education conducted for nursing students—that is, future nurses—according to these guidelines. The patient safety and nursing course was designed as an elective in the second semester of the third year. Before the class was conducted, only 6.9% of the students were familiar with the concept of patient safety. Of the 11 WHO topics, this course covers nine (excluding infection control and medicine safety) and is divided into seven modules. Three modules consist of lectures only, whereas the remaining modules involve practical training. To practice patient safety, it is essential for all healthcare professionals to acquire knowledge regarding patient safety during their undergraduate curriculum. This study aimed to provide foundational information regarding patient safety education for nursing and other healthcare students who have not yet undergone patient safety training.

Development, implementation and evaluation of a novel quality improvement and patient safety curriculum in an emergency medicine residency training program.

Proficiency in Quality Improvement and Patient Safety (QIPS) methodologies has been identified as a standard of residency training. However, there is no consensus on how to achieve these competencies. We used Kern's model of curricular development to create a QIPS curriculum for the local Emergency Medicine (EM) residency training program. The curriculum was designed following best practice recommendations for QIPS education and took the form of a 10-h educational experience including two in-person live sessions. The curriculum was delivered to a mix of local transition to practice residents and faculty members. Participants reported favorable outcomes and objectively demonstrated QIPS knowledge acquisition. This curriculum serves as a model that could be adapted by other residency training programs seeking to implement their own QIPS curricula.

A Human Factors and Systems-Thinking approach to Veterinary Patient Safety Education: Why, What, and How?

Preparing graduates to practice safely in today's increasingly complex veterinary workplaces is a key aim for veterinary educators. This requires embedding veterinary patient safety concepts into already full curricula. This teaching tip explores the benefits of incorporating human factors and systems-thinking principles into the design and delivery of veterinary patient safety education, showing how these can inform both what is taught and how. We explore what taking a human factors approach to veterinary patient safety education means, inviting educators to rethink not just curricular content but the whole approach to delivery. Advocating for the adoption of a systems-thinking-informed approach to curriculum design, we present a two-stage curriculum mapping process to support educators to embed core human factors principles as a way of thinking and doing for learners and faculty alike. Learning theories and educational design that align with human factors principles promote participatory methods and encourage collaborative experiential learning, critical thinking, and authentic application of knowledge and skills. Educators should explore opportunities presented by interprofessional education and workplace-based learning for practical application of these principles. Barriers to an integrated human factors-based patient safety curriculum include inconsistent terminology and understanding, significant faculty development requirements, and assessment challenges associated with existing regulatory and licensing requirements. Practical approaches to addressing these barriers are discussed. The recommendations outlined for the design and delivery of veterinary patient safety curricula will help ensure that institutions develop graduates that are effectively prepared for the complexity they will meet in the veterinary workplace, leading to improved patient safety and overall workplace well-being.

The patient safety curriculum: An interventional study on the effectiveness of patient safety education for Jordanian nursing students.

The purpose of the study was to assess the effectiveness of the World Health Organization's (WHO) patient safety curriculum (PSC) in improving the patient safety education for nursing students in Jordanian higher education programmes. An interventional design adopting a pre-test and post-test was used. A questionnaire survey was administered to 373 nursing students before and after the curriculum. Students were asked to complete pre-test and post-test questionnaires on self-awareness of patient safety. Students had moderate knowledge of factors that influence patient safety and scored as the highest, (mean 3.45, SD 0.94). The greatest improvement was in the role of the health organisation in error reporting (the mean difference was 0.97, P = 0.001). Taking into consideration the essential measurements, the results obtained after the post-test regarding the two patient safety topics showed a significant increase after completing the training, demonstrating that the patient safety course was effective. The study highlights the importance of developing a curriculum in nursing schools that incorporates patient safety education. The WHO PSC guide can be a great start in this domain.

Determining the psychometric properties of a written test to assess safe dental practice

IntroductionSafe practice in medicine and dentistry has been a global priority area in which large knowledge gaps are present.Patient safety strategies aim at preventing unintended damage to patients that can...

Rapid Root Cause Analysis: Improving OBGYN Resident Exposure to Quality Improvement and Patient Safety Curricula.

Introduction Each year, millions of patients in the United States experience harm as a result of the healthcare they receive. One mechanism used by health systems to learn how and why errors occur is root cause analysis (RCA). RCA teams develop action plans to create and implement systemic changes in healthcare delivery in order to prevent future harm. The American Council on Graduate Medical Education (ACGME) recognizes the importance of analyzing adverse events, and it requires that all residents participate in real or simulated patient safety activities, such as RCAs.Often, institutional RCAs necessitate the assimilation of participants on short notice and demand considerable time investment, limiting the feasible participation of graduate medical education (GME) trainees. This presents a gap between ACGME expectations and the reality of resident involvement in patient safety activities. We present the first iteration of a quality improvement project encompassing a three-hour resident physician training course with simulated RCA-experiential learning. The purpose of this project was to produce a condensed, educational RCA experience that adequately trains allGME learners to serve as informed healthcare safety advocates while also satisfying ACGME requirements. Methods The course ("rapid RCA") was conducted during protected weekly academic training. All residents of the San Antonio Uniformed Services Health Education Consortium (SAUSHEC) Obstetrics and Gynecology (OBGYN) residency program who had not previously participated in a real or simulated RCA were required to take the "rapid RCA." Pre- and post-course surveys were completed anonymously to assess baseline knowledge, new knowledge gained from the course, and attitudes toward the course and its importance to resident training. Results Fourteen OBGYN residents attended the "rapid RCA," indicating that 64% (14 out of 22) of the program had no previous experience or opportunity to participate in a real or simulated RCA. Participation in the course demonstrated a significant gain of new knowledge with an increase from 0/14 to 10/14 (71%) residents correctly answering all pre- and post-course questions, respectively (p < 0.001). Additionally, on a Likert scale from 1 to 5, with 5 indicating "expert level," residents indicated they felt more comfortable on patient safety topics after taking the course (mean pre-course score 1.85 to post-course score 3.64,p < 0.001). All participants indicated they would prefer to take the "rapid RCA" as opposed to the only available local alternative option for a simulated RCA, currently offered as a full-day intensive course. Conclusion A meaningful increase in patient safety knowledge and attitudes toward topics covered in an RCA was demonstrated through the implementation of a "rapid RCA" in OBGYN residents. We plan to incorporate this into our annual curriculum to satisfy ACMGE requirements. This format could be adapted for other specialties as applicable.

Patient safety: a flipped classroom curriculum for family medicine residents.

Addressing patient safety incidents is a complicated and challenging issue for physicians. At present, there is little training in residency programs to help prepare learners to tackle situations where harm arises as a result of healthcare delivery. In response to new accreditation mandates, we piloted a flipped classroom patient safety curriculum to help train family medicine residents to identify and address patient safety incidents in practice. Family medicine programs could consider similar case-based training for their learners to help prepare them to respond to these events and address contributory factors.

Exploring the Depth of Patient Safety and Care: An Investigation into the Knowledge and Attitudes of Healthcare Students Across Undergraduate, Graduate, and Postgraduate Levels

Background: Patient safety is a cornerstone of healthcare education, aiming to minimize harm to patients through the reduction of errors. The global emphasis on enhancing patient safety has led to the development of various tools and curricula designed to foster a culture of safety among healthcare professionals, including dental students. With the World Health Organization's endorsement of the Patient Safety Curriculum Guide, there's a recognized need to integrate patient safety principles comprehensively into healthcare training programs. Objective: This study aimed to assess the knowledge and attitudes towards patient safety among dental undergraduate, graduate, and postgraduate students across private and public sector institutes in Karachi, utilizing the Attitude to Patient Safety Questionnaire version III (APSQ-III) as a measure. Methods: A descriptive cross-sectional study was conducted, enrolling 180 participants through convenience sampling from both private and public dental schools in Karachi. The APSQ-III, a validated tool comprising 33 items across nine domains of patient safety, was employed to gather data on students' perceptions. Statistical analysis involved mean score calculations and reliability assessment using Cronbach's alpha. Results: The majority of participants were female (78.9%), with a significant number of undergraduates (169) compared to postgraduates (11). Public sector institutions accounted for a larger share of participants (98) than private (82). Overall, students demonstrated positive attitudes towards patient safety, with mean scores across all domains exceeding 5 on a 7-point Likert scale. Notably, Safety Training and Error Reporting Confidence were highlighted, with postgraduates showing particularly high scores in these areas. The reliability of the APSQ-III in this context was confirmed with a Cronbach's alpha greater than 0.8. Conclusion: The study underscores the utility of the APSQ-III in dentistry for evaluating patient safety perceptions, revealing generally positive attitudes and a sound base of knowledge among dental students in Karachi. These findings advocate for the continued emphasis on patient safety education within dental curricula to cultivate a proactive safety culture.

Improving patient safety through mandatory quality improvement (QI) education in a family medicine residency programme

Although the American College of Graduate Medical Education (ACGME) requires that medical trainees acquire competencies in patient safety and quality improvement (QI), no standard curriculum exists. We envisaged that a...

Early Immersion in Team-Based Event Review: Experiential Patient Safety Education for PGY 1 Internal Medicine Residents.

In recent years, there has been a national push to incorporate high-fidelity quality improvement and patient safety (QIPS) education into physician training programs. In fact, integration of robust patient safety education became an Accreditation Council for Graduate Medical Education (ACGME) Common Program Requirement for residency programs in 2017. We developed a curriculum to not only fulfill the ACGME's requirement but also provide PGY 1 internal medicine residents with the skills needed to become active participants in ongoing patient safety work throughout their training and careers. Our patient safety curriculum was woven into residents' existing protected educational time and supported by a standardized facilitator guide and participant workbook. It combined didactic prework with the review of recent near-miss or low-harm patient safety events, empowering residents to identify root causes and propose interventions. We successfully delivered our patient safety curriculum to 80 PGY 1 residents over the course of 2 academic years. Residents rated the curriculum as a valuable educational experience, and the event reviews they completed met most of the criteria for high-quality patient safety reviews according to the Strong String Assessment. Implementation of this standardized curriculum has allowed us to reliably and consistently incorporate experiential patient safety education into the first year of training for internal medicine residents. Unlike purely didactic sessions, our curriculum encourages active learning, building muscle memory for event reviews that enables future engagement in patient safety activities.

Challenges of integrating patient safety into nursing curricula: An integrative literature review

Introduction The World Health Organization's Multi-Professional Patient Safety (PS) Curriculum (WHO-MPSC) was introduced in 2011, which made PS content easily available for nursing educators to integrate into their own curricula. With the exception of a few developed countries that have their own PS frameworks, many countries have yet to fully integrate PS concepts in pre-licensure healthcare education. The literature reveals numerous challenges when attempting to integrate new patient safety (PS) concepts. Due to the lack of updated synthesis and appraisal of these challenges, a synthesis of findings from the literature was deemed timely and significant. Hence, a literature review was carried out to comprehensively understand the challenges. Methods An integrative review was conducted by searching electronic databases for the years 2011–2022. The Cumulative Index of Nursing and Allied Health Literature (CINAHL), MEDLINE databases and Google Scholar were searched. The search terms were barriers, challenges, nursing students and PS education. Results Twenty reviews met the inclusion criteria. Through this review, investigators were able to identify 5 major categories of challenges (educators’ characteristics, administration, programme structure, curriculum, theory–practice gap) and 17 individual challenges of PS education implementation. Conclusion The theory-practice gap, curriculum development, and programme structure are areas that should be targeted by curriculum developers in nursing education. Furthermore, it was revealed that there is a need for further research on topics such as resistance to change and individual innovativeness among nurse educators.

The Knowledge and Perceptions of Patient Safety and Patient Safety Culture During Dental Training: A Caribbean Perspective.

Patient safety and the culture of keeping patients safe are not well-researched concepts in dentistry. Research is lacking on patient safety culture in dental teaching hospitals. This study examined the knowledge and perceptions of patient safety and patient safety culture in a Caribbean dental school among clinical faculty, dental surgery assistants and recent graduates. A qualitative research design using an anonymous online open-ended questionnaire, which underwent face validity by three subject matter experts, was used to acquire data to answer three developed research questions. Qualitative data was uploaded to QDA Miner and a five-stage thematic analysis using emergent coding was used to develop themes to answer the research questions. Qualitative data was obtained from 28 respondents, 12 clinical faculty, 10 recent graduates, and 6 dental surgery assistants. Four participants graduated in 2020, 1 graduated in 2021, and 5 graduated in 2022. The ages of participants ranged from 23 to 74 years. Themes used to answer the research questions included: the application of a clinical knowledge-based framework for the understanding of patient safety, understanding the individual elements of patient safety culture, gatekeepers of patient safety, and understanding personal limitations. Clinical and curriculum leaders at this dental school should consider the introduction of a patient safety curriculum given respondents understand patient safety from a clinical experiential perspective only and many respondents perceive patient safety culture as being guided predominantly by rules and policies with clinical faculty bearing the ultimate responsibility for keeping patients safe.

Kolb Meets Quality: Applying Learning Theory to a Process Improvement and Safety Curriculum.

The healthcare landscape is changing, and the Accreditation Council for Graduate Medical Education has recognized the importance of training our physician workforce to demonstrate competency in quality, safety, and process improvement. In the renewal of our quality improvement and patient safety curriculum, we set out to create an impactful and relevant course of study using adult learning theories as a scaffold to design the curriculum and inform our teaching methods. In this Perspective, we describe a few key learning theories and demonstrate how we have used them in the teaching of quality improvement and patient safety concepts. Our intent was to create a curriculum that could equip the next generation of physicians with the knowledge, skills, and attitudes they will need to adapt to the changes they face in practice and improve their work environments.

Building Resident Quality Improvement Knowledge and Engagement Through a Longitudinal, Mentored, and Experiential Learning-Based Quality Improvement Curriculum.

Quality improvement (QI) training is an essential component of resident medical education and a part of the ACGME core competencies. We present our residency's evidence-based QI curriculum, which outlines key components identified in the literature for successful QI education. Our curriculum included a mandatory five-part longitudinal educational series during ambulatory education sessions for second-year residents. Modeled after the Institute for Healthcare Improvement model for improvement and taught by a chief resident, our curriculum introduced residents to key QI concepts through case-based, just-in-time didactics and applied experiential learning via concurrent resident-led longitudinal QI projects. Residents received structured, multilayer mentorship from a faculty mentor in their field of interest and the chief resident of quality and patient safety. Their work-in-progress projects were presented to faculty QI experts and institutional leadership for additional feedback and mentorship. Since 2016, a total of 234 internal medicine residents have completed our QI curriculum and developed 67 QI projects, which have been presented at various local, regional, and national conferences. In the 2 most recent academic years, Quality Improvement Knowledge Application Tool Revised (QIKAT-R) scores significantly increased from 4.6 precurriculum to 6.3 postcurriculum (p < .001). A longitudinal, experiential, and mentored QI curriculum teaches residents QI skill sets through incorporating mechanisms associated with successful educational initiatives and adult learning theory. Our QIKAT-R results and project output show that our curriculum is associated with improved trainee QI knowledge and systems-level improvements.

The next phase in patient safety education: Towards a standardized, tools-based pathology patient safety curriculum: A call to action from the Association of Pathology Chairs' Residency Program Directors Section Training Residents in Patient Safety Workgroup

Patient safety education is a mandated Common Program Requirement of the Accreditation Council for Graduate Medical Education and for the Royal College of Physicians and Surgeons of Canada in all medical residency and fellowship programs. Although many hospitals and healthcare environments have general patient safety education tools for trainees, few to none focus on the unique training milieu of pathologists, including a mix of highly automated and manual error-prone processes, frequent multiplicity of events, and lack of direct patient relationships for error disclosure. We established a national Association of Pathology Chairs-Program Directors Section Workgroup focused on patient safety education for pathology trainees entitled Training Residents in Patient Safety (TRIPS). TRIPS included diverse representatives from across the United States, as well as representatives from pathology organizations including the American Board of Pathology, the American Society for Clinical Pathology, the United States and Canadian Academy of Pathology, the College of American Pathologists, and the Society to Improve Diagnosis in Medicine. Objectives of the workgroup included developing a standardized patient safety curriculum, designing teaching and assessment tools, and refining them with pilot sites. Here we report the establishment of TRIPS as well as data from national needs assessment of Program Directors across the country, who confirmed the need for a standardized patient safety curriculum.

A Novel Quality Improvement and Patient Safety Curriculum for Emergency Medicine Residents

Quality improvement training during residency is a crucial component of post-graduate medical education and is one of the Association of American Medical Colleges Cross-Continuum Competencies and the six Accreditation Council for Graduate Medical Education domains of clinical competency. No national standard curriculum exists when it comes to training emergency medicine residents. A novel residency-focused QI curriculum was implemented to help emergency medicine residents develop foundational skills in QI and to translate these skills into practical projects that span multiple disciplines. The curriculum was effective, is readily adaptable to the resident physician and medical student levels, and supports the national trend toward implementing education in QI earlier in physician training.

Supporting a culture of patient safety: Resident-led patient safety event reviews in a pathology residency training program

Patient safety is a critical component of quality patient care at any healthcare institution. In order to support a culture of patient safety, and in the context of a hospital-wide patient safety initiative at our institution, we have created and implemented a new patient safety curriculum within our training program. The curriculum is embedded in an introductory course for first-year residents, in which residents gain an understanding of the multifaceted role of the pathologist in patient care. The patient safety curriculum is a resident-centered event review process and includes 1) identification and reporting of a patient safety event, 2) event investigation and review, and 3) presentation of findings to the residency program including core faculty and safety champions for the consideration of implementation of the identified systems solution. Here we discuss the development of our patient safety curriculum, which was trialed over a series of seven event reviews conducted between January 2021 and June 2022. Resident involvement in patient safety event reporting and patient safety event review outcomes were measured. All event reviews conducted thus far have resulted in the implementation of the solutions discussed during event review presentations based on cause analysis and identification of strong action items. Ultimately this pilot will serve as the basis by which we implement a sustainable curriculum in our pathology residency training program centered on supporting a culture of patient safety, and in line with ACGME requirements.

The impact of an educational program on knowledge and perception of patient safety culture among nurses in the two medical colleges of Manipur: A quasi-experimental study.

Nurses' leaders are protracted as high-leverage players who would be instrumental in initiating or bettering the culture of safety in the hospital, with no previous intervention done for the same in Manipur. The aim of this study was to assess the effectiveness of an educational intervention program on patient safety culture among nurses in Manipur. A quasi-experimental study was conducted from July 2019 to December 2021 among the 32 nurses of two tertiary-level hospitals in Manipur. A structured questionnaire and Hospital Survey on Patient Safety Culture version 2 were used (Hospital Survey on Patient Safety Culture (HSOPSC) version 2.O (AHRQ, Rockyville, Maryland, USA)). A 2-day intervention based on the WHO's Multi-Professional Patient Safety Curriculum Guide was used. Data were collected before, immediately, and 3 months after the intervention. Data were summarized using descriptive using IBM SPSS 26. Paired t-test, Chi-square test, and t-test were employed to check for differences within and between the groups, and P < 0.05 was taken as statistically significant. The mean knowledge scores were comparable between the groups at baseline (7.13 ± 3.3, 8.44 ± 3.74; P = 0.142) but differed significantly at posttest and follow-up tests (P < 0.0001). The dimensions of "staffing and work pace" and "reporting patient safety events" had the lowest positive responses from both the groups at baseline. There is a significant increase in the total safety score from baseline to posttest and follow-up in the intervention group (P < 0.001). The study asseverated the effectiveness of an educational intervention in increasing the knowledge and perception of patient safety culture, but the results highlighted the need for training at regular intervals.

Integrating patient safety education into pharmacy curriculum in Nigeria.

Recognition has been given to patient safety and healthcare quality as central components of a functional health system which has resulted in increased advocacy for elaborate patient safety content in education and training programmes for health professionals. The World Health Organisation's patient safety curriculum is an evidence-based framework that provides a valuable resource for the training of healthcare professionals in enhancing patient safety. Other international organisations have also advocated for the need to restructure healthcare professionals' education to include the concept of patient safety. The ideal time to initiate patient safety education is suggested to be during schooling through curricula that inculcate learning from adverse events. This will prepare pharmacy students as future healthcare professionals who will become better prepared for clinical practice leading to improved healthcare quality and safety.

Implementation of a resident-led patient safety curriculum.

The Royal College of Physicians and Surgeons of Canada has made Quality Improvement and Patient Safety (QIPS) a priority in residency education, however, implementation is limited by the heterogeneity of previously published curricula. We created a longitudinal resident-led patient safety (PS) curriculum using relatable, real-life PS incidents (PSIs) and an analysis framework.Implementation was feasible, well received by residents and demonstrated significant improvement in residents' PS knowledge,skills, and attitudes. Our curriculum built a culture of PS within a pediatric residency program, promoted engagement in QIPS practices early in training, and filled a gap in the current curriculum teaching.