BMJ Qual Saf 22:843-854 doi:10.1136/bmjqs-2013-001905
  • Original research

Patient safety in healthcare preregistration educational curricula: multiple case study-based investigations of eight medicine, nursing, pharmacy and physiotherapy university courses

  1. on behalf of the Patient Safety Education Research Group
  1. 1The School of Health in Social Science, The University of Edinburgh, Edinburgh, UK
  2. 2Primary Care Group, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK
  3. 3Faculty of Health and Life Sciences, Northumbria University, Newcastle, Tyne and Wear, UK
  4. 4School of Pharmacy and Pharmaceutical Sciences, NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, University of Manchester, Manchester, UK
  5. 5Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK
  6. 6Faculty of Health and Medical Sciences, University of Surrey, Centre for Research in Nursing and Midwifery Education, Guildford, UK
  7. 7University of East Anglia, Norwich Research Park, Norwich, UK
  8. 8eHealth Research Group, Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK
  1. Correspondence to Dr K Cresswell, The School of Health in Social Science, The University of Edinburgh, Edinburgh EH8 9DX UK; Kathrin.Beyer{at}
  • Received 11 February 2013
  • Revised 27 April 2013
  • Accepted 10 May 2013
  • Published Online First 1 June 2013


Background We sought to investigate the formal and informal ways preregistration students from medicine, nursing, pharmacy and the allied healthcare professions learn about patient safety.

Methods We drew on Eraut's framework on formal and informal acquisition of professional knowledge to undertake a series of phased theoretically informed, in-depth comparative qualitative case studies of eight university courses. We collected policy and course documentation; interviews and focus groups with educators, students, health service staff, patients and policy makers; and course and work placement observations. Data were analysed thematically extracting emerging themes from different phases of data collection within cases, and then comparing these across cases.

Results We conducted 38 focus groups with a total of 162 participants, undertook 82 observations of practice placements/learning activities and 33 semistructured interviews, and analysed 44 key documents. Patient safety tended to be either implicit in curricula or explicitly identified in a limited number of discrete topic areas. Students were predominantly taught about safety-related issues in isolation, with the consequence of only limited opportunities for interprofessional learning and bridging the gaps between educational, practice and policy contexts. Although patient safety role models were key to student learning in helping to develop and maintain a consistent safety ethos, their numbers were limited.

Conclusions Consideration needs to be given to the appointment of curriculum leads for patient safety who should be encouraged to work strategically across disciplines and topic areas; development of stronger links with organisational systems to promote student engagement with organisation-based patient safety practice; and role models should help students to make connections between theoretical considerations and routine clinical care.

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