Patient Safety in Medical Education

When searching in pubmed for the two mesh terms “patient safety” and “medical education” results in 8 hits. Some research articles and editorials. One quote with literature reference about the extend of the problem is:

Our health care system today has an adverse event rate approximately equal to that of driving an automobile putting patients at a significant risk

The trouble as stated in this excellent editorial in Academic Medicine is the culture in which most health care professional work. Unfortunately working in a health care setting is mostly not about preventing errors or finding solutions to errors as in other sorts of organizations such as with airliner pilots or the military. In those organizations errors are part of their work. They are all expected to be part of the solution to errors than part of the problem. We in health care should also be a part of the solution and put all efforts to achieve succes in fighting against and preventing errors.

Medical education should be the place to start with teaching about the subjects of patient safety.

Research about patient safety is mostly done on procedures such as placing bloodstream catheters in Intensive Care Units. Simulation-based training reduces medical error, enhances clinical outcomes, and reduces the cost of clinical care. Examples in medicine for simulation based training are: laparoscopic surgery, anesthesiology with wireless machines that can blink, breathe, and simulate a plethora of medical illnesses.

It is absolutely the time for physicians, hospital managers, policy makers, patients, and the public alike to demand resources for the development of simulation centers that house modern equipment, with expert faculty to train the physicians of today. These processes must be integrated into the structure of current medical curricula, in order to achieve the highest possible outcomes for our patients.

More applications are on their way with progressing technical possibilities. There’s even a website for the Advanced Initiatives in Medical Simulation. It’s a lobbying coalition of individuals, organizations, and companies who wish to promote medical simulation in order to enhance patient safety, with concomitant error and cost reduction.

Health professions education efforts must require critical safety-related competencies and assess students’ safety knowledge, skills, and behaviors with as much fervor as their knowledge of the Krebs cycle and their ability to determine the differential diagnosis of weight loss.

These elemaents should be in the formal curricula. Every team member should be responsible for patient safety and hierarchie should be leveled. What do you think?

Wagner, D., Noel, M., Barry, H., & Reznich, C. (2011). Safe Expectations Academic Medicine, 86 (11) DOI: 10.1097/ACM.0b013e3182327c81

Aggarwal, R., & Darzi, A. (2011). Simulation to Enhance Patient Safety: Why Aren’t We There Yet? Chest, 140 (4), 854-858 DOI: 10.1378/chest.11-0728