BMJ Qual Saf 21:416-422 doi:10.1136/bmjqs-2011-000463
  • Innovations in education

Development and evaluation of a 3-day patient safety curriculum to advance knowledge, self-efficacy and system thinking among medical students

  1. Peter Pronovost2,3,4
  1. 1Division of Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
  2. 2Armstrong Institute for Safety and Quality, Johns Hopkins Medicine, Baltimore, Maryland, USA
  3. 3Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
  4. 4Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  5. 5Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  6. 6Nursing Clinical Quality and Magnet, The Johns Hopkins Hospital, Baltimore, Maryland, USA
  7. 7Office of Medical Education Services, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
  8. 8The Johns Hopkins Hospital, Baltimore, Maryland, USA
  1. Correspondence to Dr Hanan J Aboumatar, Assistant Professor, Department of Medicine, Division of Internal Medicine, Johns Hopkins School of Medicine, Education & Research Associate, Center for Innovations in Quality Patient Care, Johns Hopkins Medicine, 601 North Caroline Street, Suite 2080, Baltimore, MD 21287-0765, USA; habouma1{at}
  1. Contributors HA initiated and designed the study, conducted the intervention, analysed the data, drafted and revised the manuscript. DT, AW, PD, JM, PK, LL, and LP conducted the intervention and revised the manuscript. JC contributed to the data collection and analysis. PP contributed to study initiation and design, conducted the intervention and revised the manuscript.

  • Accepted 25 January 2012
  • Published Online First 15 March 2012


Purpose To develop a patient safety curriculum and evaluate its impact on medical students' safety knowledge, self-efficacy and system thinking.

Methods This study reports on curriculum development and evaluation of a 3-day, clinically oriented patient safety intersession that was implemented at the Johns Hopkins School of Medicine in January 2011. Using simulation, skills demonstrations, small group exercises and case studies, this intersession focuses on improving students' teamwork and communication skills and system-based thinking while teaching on the causes of preventable harm and evidence-based strategies for harm prevention. One hundred and twenty students participated in this intersession as part of their required second year curriculum. A pre–post assessment of students' safety knowledge, self-efficacy in safety skills and system-based thinking was conducted. Student satisfaction data were also collected.

Results Students' safety knowledge scores significantly improved (mean +19% points; 95% CI 17.0 to 21.6; p<0.01). Composite system thinking scores increased from a mean pre-intersession score of 60.1 to a post-intersession score of 67.6 (p<0.01). Students had statistically significant increases in self-efficacy for all taught communication and safety skills. Participant satisfaction with the intersession was high.

Conclusions The patient safety intersession resulted in increased knowledge, system-based thinking, and self-efficacy scores among students. Similar intersessions can be implemented at medical, nursing, pharmacy and other allied health schools separately or jointly as part of required school curricula. Further study of the long-term impact of such education on knowledge, skills, attitudes and behaviours of students is warranted.


  • Other disclosures: The lead author of this paper ‘had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis’.

  • This manuscript is not under consideration at any other journal. All those who qualify to be authors of this work are listed above and meet criteria for authorship. The authors take responsibility for and agree with the data presented and report no conflict of interest. No similar manuscript based on this study has been submitted or published.

  • Funding This intersession was supported by funds from the Johns Hopkins School of Medicine.

  • Competing interests None.

  • Ethics approval Johns Hopkins Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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