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Who Patient Safety Curriculum Guide for Medical Schools

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Who Patient Safety Curriculum Guide for Medical Schools WORLD ALLIANCE FOR PATIENT SAFETY WHO PATIENT SAFETY CURRICULUM GUIDE FOR MEDICAL SCHOOLS A SUMMARY DOWNLOAD THE GUIDE FOR FREE AT: http://www.who.int/patient safety/activities/technical/medical_curriculum/en/index.html © World Health Organization 2009 WHO/IER/PSP/2009.3S All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; e-mail: [email protected]). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. Printed in the United Kingdom Curriculum Guide: a summary Background advantages to introducing both of these With the growing recognition of the simultaneously. The number of topics harms caused by health care comes the covered may be increased over time to need for medical students to learn how ease implementation. to deliver safer care. The Curriculum Guide aims to support medical schools Some aspects of patient safety link in worldwide in implementing patient safety well with existing subjects and can be education by providing a comprehensive incorporated into existing sessions. curriculum for patient safety, to promote Others are relatively new and are likely to and enhance the status of patient safety dedicated sessions. A balance must be worldwide and ultimately to prepare struck between integration of material students for safe practice. into existing curriculum and ability to coordinate delivery effectively. The Australian Patient Safety Education Principles of patient safety teaching Framework was used to derive 11 topics and learning for the Curriculum Guide. Topics within the Curriculum are designed to stand Patient safety education can be alone, each with content for 60-90 integrated into procedural skills training minutes’ teaching and include a variety programmes. A number of different of ideas for implementation and patient safety topics may be relevant in assessment. any given procedure, and those taught for one procedure often also apply Implementation generally. Early steps include identifying learning outcomes, mapping patient safety to Patient safety education can be made existing curriculum and then assessing meaningful to students by placing the capacity within the faculty to deliver the principles in context with their current patient safety Curriculum and engaging and future practical roles, using relevant in capacity building work. examples of safety and giving students an opportunity to practise their patient Decisions regarding delivery of patient safety knowledge and skills. safety material will depend on the nature and content of existing curriculum, but Students learn better in a safe supportive may be matched to current educational learning environment, one which is formats. The curriculum addresses challenging but not intimidating and student knowledge and performance where experiential learning is facilitated. elements of patient safety, and there are Educators may adopt a variety of styles including roles as information provider, 1 role model, facilitator, assessor, planner groups, individual interviews, observation and resource provider. There is an and docements/records. Findings of important role for patients in delivering evaluation must be disseminated and patient safety education. action taken where appropriate. Assessing patient safety Patient safety education activities Assessments may be formative or A number of different educational formats summative, and these may be in-course may be used in the delivery of the or end-of-course. Assessments strongly Curriculum, including lectures, ward influence study behaviour and learning round-based teaching, small group outcomes for students and therefore learning, case based discussions, should align with desired learning independent study, patient tracking, role outcomes. Blueprinting defines the play, simulation and undertaking competencies students are expected to improvement projects. Each of these has meet, and can be used to map patient benefits and challenges, and different safety topics across the curriculum as a methods are appropriate for different whole. The purpose of assessment learning goals. should drive the choice of format – for example, written (e.g. multiple choice Transnational Approach questions, modified essays, logbooks) or Health care is now globalized, and practical (e.g. direct observation, case- medical education should reflect this. based discussions, OSCE). The Curriculum Guide operates on universal principles that are applicable Evaluating patient safety globally, and though delivery should be Evaluation measures how and what is customized to local needs and culture. taught in the curriculum by collecting There is a need for international human data from students, patients, teachers and physical resource capacity building and/or other stakeholders. Choices must on an international level. be made about what is being evaluated, who the evaluation is for and what Introduction to topics questions the evaluation is trying to As future clinicians students need to answer. There are different types of learn about patient safety. There is a evaluation – proactive, clarificative, progression from knowing “what” to interactive, monitoring and impact – each knowing “how” and ultimately to “doing”. answering the different questions Best learning is through hands-on evaluation can ask. Data for evaluation experience with feedback from trainers, may be gathered in a number of ways – along with mentoring and coaching. self-reflection, questionnaires, focus There are a number of cultural barriers to 2 change which students can be helped to complex that the successful treatment explore and challenge. The Curriculum and outcome for each patient depends can be integrated with clinical care (eg on a range of factors, not just the infection control). Students need to learn competence of an individual health care to practise safe health care even if the provider. When so many people and prevailing medical culture is not different types of health-care providers supportive of this, and to learn to deal (doctors, nurses, pharmacists and allied with the conflicts this may create. health) are involved, it is very difficult to ensure safe care unless the system of Topic 1: What is patient safety? care is designed to facilitate timely and Health professionals are increasingly complete information and understanding being required to incorporate patient by all the health professionals. This topic safety principles and concepts into presents the case for patient safety. everyday practice. In 2002, WHO Member States agreed on a World Topic 2: What is human factors and Health Assembly resolution on patient why is it important to patient safety? safety because they saw the need to Human factors, engineering or reduce the harm and suffering of patients ergonomics is the science of the and their families as well as the interrelationship between humans, their compelling evidence of the economic tools and the environment in which they benefits of improving patient safety. live and work [3]. Human factors Studies show that additional engineering will help students hospitalization, litigation costs, infections understand how people perform under acquired in hospitals, lost income, different circumstances so that systems disability and medical expenses have and products can be built to enhance cost some countries between US$ 6 performance. It covers the human– billion and US$ 29 billion a year. A machine and human-to-human number of countries have published interactions such as communication, studies highlighting the overwhelming teamwork and organizational culture. evidence showing that significant Other industries such as aviation, numbers of patients are harmed due to manufacturing and the military have their health care, either resulting in successfully applied knowledge of permanent injury, increased length of human factors to improve systems and stay in hospitals or even death. We have services. Students need to understand learnt over the last decade that adverse how human factors can be used to events occur not because bad people
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