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A patient safety course for preclinical medical students


  • Funding: This study was funded internally by the University of Miami Miller School of Medicine.

  • Conflict of interest: None.

  • Ethical approval: The study describes a portion of a mandatory curriculum, and is therefore exempt.

Corresponding author’s contact details: David Birnbach, University of Miami, Jackson Memorial Hospital, Center for Patient Safety, 1611 NW 12th Avenue, Miami, FL 33136 USA. E-mail:


Background:  We developed a course to introduce incoming third-year medical students to the subject of patient safety, to focus their attention on teamwork and communication, and to create an awareness of patient-safe practices that will positively impact their performance as clinicians.

Methods:  The course, held prior to the start of clinical rotations, consisted of lectures, web-based didactic materials, small group activities and simulation exercises, with an emphasis on experiential learning. First, students inspected a ‘room of horrors’, which is a simulated clinical environment riddled with errors. Second, we used lenticular puzzles in small groups to elicit teamwork behaviours that parallel real-life interactions in health care. Each team was given 8 minutes to complete a 48-piece puzzle, with five pieces removed at random and given to other teams. The salient teaching point of this exercise is that for a team to complete the task, team members must communicate with members of their own team as well as with other teams. Last, simulation scenarios provided a clinical context to reinforce the skills introduced through the puzzle exercise and lectures. The students were split into groups of six or seven members and challenged with two scenarios. Both scenarios focused on a 56-year-old man in respiratory distress. The teams were debriefed on both clinical management and teamwork.

Results:  The vast majority of the students (93%) agreed that the course improved their patient safety knowledge and skills.

Discussion:  The positive response from students to the introductory course is an important step in fostering a culture of patient safety.