Korean Medical Education Review (의학교육논단)

Yonsei university college of medicine (연세대학교 의과대학)
권호 표지
DOI QR코드

DOI QR Code

Patient Safety Education for Medical Students: Global Trends and Korea's Status

의과대학생을 위한 환자안전 교육의 국제적 동향 및 국내 현황

  • Roh, HyeRin (Department of Medical Education, Inje University College of Medicine)
  • 노혜린 (인제대학교 의과대학 의학교육학교실)
  • Received : 2019.01.31
  • Accepted : 2019.02.18
  • Published : 2019.02.28
Download PDF
⟨ Previous Next ⟩

Abstract

This study is a narrative review introducing global trends in patient safety education within medical schools and exploring the status of Korean education. Core competences for patient safety include patient centeredness, teamwork, evidence- and information-based practice, quality improvement, addressing medical errors, managing human factors and system complexity, and patient safety knowledge and responsibility. According to a Korean report addressing the role of doctors, patient safety was described as a subcategory of clinical care. Doctors' roles in patient safety included taking precautions, educating patients about the side effects of drugs, and implementing rapid treatment and appropriate follow-up when patient safety is compromised. The Korean Association of Medical Colleges suggested patient safety competence as one of eight essential human and society-centered learning outcomes. They included appropriate attitude and knowledge, human factors, a systematic approach, teamwork skills, engaging with patients and carers, and dealing with common errors. Four Korean medical schools reported integration of a patient safety course in their preclinical curriculum. Studies have shown that students experience difficulty in reporting medical errors because of hierarchical culture. It seems that patient safety is considered in a narrow sense and its education is limited in Korea. Patient safety is not a topic for dealing with only adverse events, but a science to prevent and detect early system failure. Patient safety emphasizes patient perspectives, so it has a different paradigm of medical ethics and professionalism, which have doctor-centered perspectives. Medical educators in Korea should understand patient safety concepts to implement patient safety curriculum. Further research should be done on communication in hierarchical culture and patient safety education during clerkship.

Keywords

Table 1. Medical Students' core competences and curriculum contents for patient safety

OHKOCT_2019_v21n1_1_t0001.png 이미지

Table 2. Korean medical students' core competences for patient safety

OHKOCT_2019_v21n1_1_t0002.png 이미지

References

  1. Kohn LT, Corrigan J, Donaldson MS. To err is human: building a safer health system. Washington (DC): National Academy Press; 2000.
  2. Brennan TA, Leape LL, Laird NM, Hebert L, Localio AR, Lawthers AG, et al. Incidence of adverse events and negligence in hospitalized patients: results of the Harvard Medical Practice Study I. N Engl J Med. 1991;324(6):370-6. https://doi.org/10.1056/NEJM199102073240604
  3. Leape LL, Brennan TA, Laird N, Lawthers AG, Localio AR, Barnes BA, et al. The nature of adverse events in hospitalized patients: results of the Harvard Medical Practice Study II. N Engl J Med. 1991;324(6):377-84. https://doi.org/10.1056/NEJM199102073240605
  4. Gallagher TH, Waterman AD, Ebers AG, Fraser VJ, Levinson W. Patients' and physicians' attitudes regarding the disclosure of medical errors. JAMA. 2003;289(8):1001-7. https://doi.org/10.1001/jama.289.8.1001
  5. Burroughs TE, Waterman AD, Gallagher TH, Waterman B, Jeffe DB, Dunagan WC, et al. Patients' concerns about medical errors during hospitalization. Jt Comm J Qual Patient Saf. 2007;33(1):5-14. https://doi.org/10.1016/S1553-7250(07)33002-X
  6. Lee YM. Patient safety curriculum in medical education. Korean J Med Educ. 2009;21(3):217-28. https://doi.org/10.3946/kjme.2009.21.3.217
  7. Greiner AC, Knebel E. Health professions education: a bridge to quality. Washington (DC): National Academy Press; 2003.
  8. Goode LD, Clancy CM, Kimball HR, Meyer G, Eisenberg JM. When is "good enough?": the role and responsibility of physicians to improve patient safety. Acad Med. 2002;77(10):947-52. https://doi.org/10.1097/00001888-200210000-00004
  9. Kachalia A, Johnson JK, Miller S, Brennan T. The incorporation of patient safety into board certification examinations. Acad Med. 2006;81(4):317-25. https://doi.org/10.1097/00001888-200604000-00004
  10. Joint Committee of the Group on Resident Affairs and Organization of Resident Representatives. Patient safety and graduate medical education [Internet]. Washington (DC): Association of American Medical Colleges; 2003 [cited 2019 Jan 19]. Available from: https://members.aamc.org/eweb/upload/patient%20safety%20gme.pdf.
  11. Sandars J, Bax N, Mayer D, Wass V, Vickers R. Educating undergraduate medical students about patient safety: priority areas for curriculum development. Med Teach. 2007;29(1):60-1. https://doi.org/10.1080/01421590601087546
  12. Donaldson LJ, Fletcher MG. The WHO World Alliance for Patient Safety: towards the years of living less dangerously. Med J Aust. 2006;184(10 Suppl):S69-72.
  13. World Health Organization. WHO patient safety curriculum guide for medical schools. Geneva: World Health Organization; 2009 [cited 2019 Jan 19]. Available from: http://apps.who.int/iris/handle/10665/44091.
  14. Myung SJ, Shin JS, Kim JH, Roh H, Kim Y, Kim J, et al. The patient safety curriculum for undergraduate medical students as a first step toward improving patient safety. J Surg Educ. 2012;69(5):659-64. https://doi.org/10.1016/j.jsurg.2012.04.012
  15. Lee HY, Lee SG. Medical students' perceptions and intentions regarding patient safety. Qual Improv Health Care. 2018;24(1):23-9. https://doi.org/10.14371/QIH.2018.24.1.23
  16. Kim YH, Roh HR. Students' perception of their achievement of clinical competency for patient safety. Korean J Med Educ. 2007;19(3):207-14. https://doi.org/10.3946/kjme.2007.19.3.207
  17. Lee SH, Shin YH, Kim SS. Comparing attitudes toward disclosing medical errors between medical students and interns. Korean J Med Educ. 2012;24(3):247-58. https://doi.org/10.3946/kjme.2012.24.3.247
  18. Roh H, Park SJ, Kim T. Patient safety education to change medical students' attitudes and sense of responsibility. Med Teach. 2015;37(10):908-14. https://doi.org/10.3109/0142159X.2014.970988
  19. Ahn D. The future roles of Korean doctors: cultivating well-rounded doctors. Korean Med Educ Rev. 2014;16(3):119-25. https://doi.org/10.17496/kmer.2014.16.3.119
  20. Korean Association of Medical Colleges. Learning outcomes of basic medical education: human and society-centered. Seoul: Gabyumunhwasa; 2017.
  21. Roh HR, Seol HJ, Kang SS, Suh IB, Ryu SM. Using medical error cases for patient safety education. Korean J Med Educ. 2008;20(3):265-71. https://doi.org/10.3946/kjme.2008.20.3.265
  22. Roh H, Lee KU, Lee YS, Kim OJ, Kim SW, Choi JW. Effect of patient safety education in surgical clerkship to develop competencies for managing and preventing medical errors. Korean J Med Educ. 2010;22(4):303-11. https://doi.org/10.3946/kjme.2010.22.4.303
  23. Lee SH, Shin JS, Huh NH, Yoon HB. A pilot study on developing a patient safety curriculum using the consensus workshop method. Korean Med Educ Rev. 2013:15(3):151-8. https://doi.org/10.17496/KMER.2013.15.3.151
  24. Seiden SC, Galvan C, Lamm R. Role of medical students in preventing patient harm and enhancing patient safety. Qual Saf Health Care. 2006;15(4):272-6. https://doi.org/10.1136/qshc.2006.018044
  25. The Australian Council for Safety and Quality in Health Care. National patient safety education framework [Internet]. Sydney: The Australian Council for Safety and Quality in Health Care; 2005 [cited 2019 Jan 19]. Available from: https://www.safetyandquality.gov.au/wp-content/uploads/2012/06/National-Patient-Safety-Education-Framework-2005.pdf.
  26. Mayer D, Klamen DL, Gunderson A, Barach P; Telluride Interdisciplinary Roundtable. Designing a patient safety undergraduate medical curriculum: the Telluride Interdisciplinary Roundtable experience. Teach Learn Med. 2009;21(1):52-8. https://doi.org/10.1080/10401330802574090
  27. Korean Medical Association. Korean doctor's role. Seoul: Korean Medical Association; 2014.
  28. Walton M, Woodward H, Van Staalduinen S, Lemer C, Greaves F, Noble D, et al. Republished paper: the WHO patient safety curriculum guide for medical schools. Postgrad Med J. 2011;87(1026):317-21. https://doi.org/10.1136/pgmj.2009.036970rep
  29. Walton M, Kerridge I. Do no harm: is it time to rethink the Hippocratic Oath? Med Educ. 2014;48(1):17-27. https://doi.org/10.1111/medu.12275
  30. Hall LW, Scott SD, Cox KR, Gosbee JW, Boshard BJ, Moylan K, et al. Effectiveness of patient safety training in equipping medical students to recognise safety hazards and propose robust interventions. Qual Saf Health Care. 2010;19(1):3-8. https://doi.org/10.1136/qshc.2008.031781
  31. Martinez W, Lo B. Medical students' experiences with medical errors: an analysis of medical student essays. Med Educ. 2008;42(7):733-41. https://doi.org/10.1111/j.1365-2923.2008.03109.x
  32. Walton MM. Hierarchies: the Berlin Wall of patient safety. Qual Saf Health Care. 2006;15(4):229-30. https://doi.org/10.1136/qshc.2006.019240