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A Guide for Developing Patient Safety Curricula for Undergraduate Medical Education

In its 1999 report, the Institute of Medicine identified medical error as an important factor in mortality of hospitalized patients, contributing to as many as 98,000 deaths annually.1 These errors are costly as well, incurring an annual cost of as much as 30 billion dollars in lost income and excessive health care expenditures. As prevalent as these errors are, 35% of internal medicine clerkship directors had, in 2000, “little or no familiarity with the Institute of Medicine's report.”2 This unacceptable level of error in health care, and lack of awareness of its importance send a clear call to educators to address the issue of patient safety. This call extends to all dimensions of medical education, including undergraduate medical education.3 In fact, one could argue that patient safety belongs first in a medical school curriculum, and that it should be an ongoing educational endeavor, one that continues throughout a physician's career. However, one may justifiably wonder about the optimal method for implementing a patient safety curriculum in the medical school.

Many approaches to undergraduate medical education have included an informatics-based platform. In particular, the design and implementation of computer-based instructional materials have revolutionized the way preclinical and clinical subjects have been taught in medical schools over the past decade. Very few of these materials, however, have focused on patient safety, and given their success in preclinical and clinical domains, an informatics-centric approach to teaching patient safety should be considered.

The evidence of need for a medical school curriculum related to patient safety is compelling. It has been observed that physician trainees use the mechanisms of denial, discounting, and distancing to define and defend medical error.4 In a review of medical error, Lester and Tritter noted that recurrent themes in errors, such as uncertainty, fallibility, and exclusivity of …