Patient safety in health care professional educational curricula: examining the learning experience
Patient safety is one of the new ‘buzz-words’ of practice – but little is known about how people learn to practice safely. This two and a half year research project was funded by the Department of Health (Patient Safety Research Programme). This was a collaborative study led by Newcastle University which involves the Universities of East Anglia, Edinburgh, Manchester, and Surrey. The project focuses on four professional groups: Medicine, Nursing, Pharmacy, and Physiotherapy.
This study has investigated the formal and informal ways pre-registration students from four healthcare professions learn about patient safety in order to become safe practitioners. The study aims to understand some of the issues which impact upon teaching, learning and practising patient safety in academic, organisational and practice ‘knowledge’ contexts.
NHS policy is being taken seriously by course leaders, and Patient Safety material is being incorporated into both formal and informal curricula. Patient safety in the curriculum is largely implicit rather than explicit. All students very much value the practice context for learning about patient safety. However, resource issues, peer pressure and client factors can influence safe practice. Variations exist in students’ experience, in approach between university tutors, different placement locations – the experience each offers – and the quality of the supervision available. Relationships with the mentor or clinical educator are vital to student learning. The role model offered and the relationship established affects how confident students feel to challenge unsafe practice in others. Clinicians are conscious of the tension between their responsibilities as clinicians (keeping patients safe), and as educators (allowing students to learn under supervision).
There are some apparent gaps in curricular content where relevant evidence already exists – these include the epidemiology of adverse events and error, root cause analysis and quality assessment. Reference to the organisational context is often absent from course content and exposure limited. For example, incident reporting is not being incorporated to any great extent in undergraduate curricula. Newly qualified staff were aware of the need to be seen to practice in an evidence based way, and, for some at least, the need to modify ‘the standard’ way of doing things to do ‘what’s best for the patient’.
A number of recommendations have been made, some generic and others specific to individual professions. Regulators’ expectations of courses in relation to patient safety education should be explicit and regularly reviewed. Educators in all disciplines need to be effective role models who are clear about how to help students to learn about patient safety. All courses should be able to highlight a vertical integrated thread of teaching and learning related to patient safety in their curricula. This should be clear to staff and students. Assessment for this element should also be identifiable as assessment remains important in driving learning. All students need to be enabled to constructively challenge unsafe or non-standard practice. Encounters with patients and learning about their experiences and concerns are helpful in consolidating learning. Further innovative approaches should be developed to make patient safety issues ‘real’ for students.
View the full report (pdf)
Visit the Patient Safety web-site.
Main Contact
Dr Pauline Pearson, Project Director, medev@ncl.ac.uk.
