Educating undergraduate medical students about patient safety: Priority areas for curriculum development

Learning about patient safety is an important aspect of undergraduate medical curricula but there are no clear priority areas. A recent consensus of international medical educators identified several priority areas and these recommendations include approaches to increase knowledge of patient safety, including the causes and frequency, to develop willingness to take responsibility, to develop self awareness of the situations when patient safety is compromised, to develop communication skills, especially inter-personal, and to develop team working skills. Patient safety is a major priority for all healthcare providers and it is a reasonable expectation that all undergraduate medical students should have the necessary competence to ensure that harm to patients is minimized in their future career as a doctor. This raises several important questions: What should be learned, when should it be taught and how should it be taught? These questions appear at first sight to be obvious but teaching and learning about patient safety in undergraduate medical education offers a challenge to all medical schools. The main challenge is to ensure that patient safety is regarded as an essential aspect of the undergraduate medical curriculum. In addition, there is the real dilemma of how it can be included in an already crowded curriculum. These difficulties are compounded by the wide variety of statements on what should be learned, with a range from vague broad aims to long lists of detailed intended learning outcomes. There is an urgent need to clearly identify the main priorities for patient safety in undergraduate medical education. A symposium on patient safety education was recently held at AMEE (2006) and an important outcome was the development of several key recommendations for patient safety education. This was produced by using an electronic audience response system to identify the opinions of the 86 international participants in the symposium. All participants stated that education on patient safety was important in undergraduate medial education and 37% had already implemented a patient safety curriculum. However, only 7% stated that they thought that they were doing enough in their curriculum. The main priorities stated by participants included a variety of both specific and more generalized aspects of patient safety (Table 1). It was recommended that all students should increase their knowledge and awareness of patient safety, including the causes and frequency. This aspect was also associated with the need to encourage students to accept that they have an individual—and a collective—responsibility for improving and maintaining patient safety. The development of self-awareness of the situations when patient safety is compromised was regarded as being important, such as when working under pressure. The more generic skills of inter-personal communication and team-working were identified as essential competences. Other priorities included the need to develop skills in a range of areas, including root-cause analysis, safe prescribing and procedures, the empowerment of patients to have an involvement in patient safety and dealing with the aftermath of errors, in both doctors and patients.