Can teaching medical students to investigate medication errors change their attitudes towards patient safety? Robert A Dudas, 1,2 David G Bundy, 1,3 Marlene R Miller, 1,3,4 Michael Barone 1 ABSTRACT Background: The purpose of this study was to evaluate the impact of a patient-safety curriculum administered during a paediatric clerkship on medical students’ attitudes towards patient safety. Methods: Medical students viewed an online video introducing them to systems-based analyses of medical errors. Faculty presented an example of a medication administration error and demonstrated use of the Learning From Defects tool to investigate the defect. Student groups identified and then analysed medication errors during their clinical rotation using the Learning From Defects framework to organise and present their findings. Outcomes included patient safety attitudinal changes, as measured by questions derived from the Safety Attitudes Questionnaire. Results: 108 students completed the curriculum between July 2008 and July 2009. All student groups (25 total) identified, analysed and presented patient safety concerns. Curriculum effectiveness was demonstrated by significant changes on questionnaire items related to patient safety attitudes. The majority of students felt that the curriculum was relevant to their clinical rotation and should remain part of the clerkship. Conclusions: An active learning curriculum integrated into a clinical clerkship can change learners’ attitudes towards patient safety. Students found the curriculum relevant and recommended its continuation. The Association of American Medical Colleges (AAMC) Medical School Objectives Project report recommends that medical schools deliver patient safety education to undergraduates. 1 Additionally, the Liaison Committee on Medical Education (LCME) surveys patient safety content in all accredited medical school curricula as part of the standards for the educational programme of medical schools. 2 Much of the published literature about patient safety education is directed towards graduate medical education and practising phys- icians. 3e5 Despite increasing calls to educate medical students about these issues, few medical schools have developed and evalu- ated patient safety curricula. 6e11 A recent national survey of US and Canadian Medical Schools suggests that very few schools have explicit patient safety curricula, and most existing curricula are based in lectures or small group discussions. 12 Medication errors in hospitals have been reported to occur with alarming frequency with the great majority involving junior doctors recently graduating from medical school. 13 We asked our students to seek out such errors during their clinical experiences and taught them a systems-based approach to analyse the error. We wanted to offer students an experiential opportunity where they could apply recently learnt information during their daily activities to establish the connec- tions between information and application. Prior work has suggested that interactive modalities are preferred to more passive methods such as lectures. 10 14 In this paper, we describe the development and imple- mentation of a novel curriculum focussing on medication errors within a paediatric clerkship at a large academic medical centre. We hypothesised that this exercise would impact medical student attitudes towards patient safety. Safety attitudes contribute to the safety climate of a healthcare institution and are believed to lead to improvements in overall patient safety. 15 16 METHODS Learner population In the 2008e2009 academic year, 108 medical students were asked to participate in and evaluate the curriculum as part of their 9-week paediatric clerkship. Students included those in their second, third and fourth years. This study was based at Johns 1 Johns Hopkins University School of Medicine, Baltimore, Maryland, USA 2 Johns Hopkins Bayview Medical Center, Baltimore, Maryland, USA 3 Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health in Baltimore, Baltimore, Maryland, USA 4 Johns Hopkins Children’s Center in Baltimore, Baltimore, Maryland, USA Correspondence to Dr Robert Dudas, Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, 4940 Eastern Ave Baltimore MD 21224, USA; rdudas@jhmi.edu Accepted 25 October 2010 Published Online First 12 January 2011 BMJ Qual Saf 2011;20:319e325. doi:10.1136/bmjqs.2010.041376 319 Original research group.bmj.com on March 20, 2013 - Published by qualitysafety.bmj.com Downloaded from