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Mainstreaming quality and safety: a reformulation of quality and safety education for health professions students
  1. Molly Cooke1,
  2. Pamela M Ironside2,
  3. Gregory S Ogrinc3
  1. 1Department of Medicine, UCSF, San Francisco, California, USA
  2. 2Center for Research on Nursing Education, Indiana University, Indianapolis, Indiana, USA
  3. 3Departments of Community and Family Medicine and Medicine, Dartmouth Medical School, Hanover, New Hampshire, USA
  1. Correspondence to Molly Cooke, Professor of Medicine, UCSF, Box 0563 LR-102, San Francisco, CA 94143-0563, USA; mcooke{at}


The urgent need to expand the ability of health professionals to improve the quality and safety of patient care in the USA has been well documented. Yet the current methods of teaching quality and safety to health professionals are inadequate for the task. To the extent that quality and safety are addressed at all, they are taught using pedagogies with a narrow focus on content transmission, didactic sessions that are spatially and temporally distant from clinical work, and quality and safety projects segregated from the provision of actual patient care. In this article an argument for a transformative reorientation in quality and safety education for health professions is made. This transformation will require new pedagogies in which a) quality improvement is an integral part of all clinical encounters, b) health professions students and their clinical teachers become co-learners working together to improve patient outcomes and systems of care, c) improvement work is envisioned as the interdependent collaboration of a set of professionals with different backgrounds and perspectives skilfully optimising their work processes for the benefit of patients, and d) assessment in health professions education focuses on not just individual performance but also how the care team's patients fared and how the systems of care were improved.

  • Graduate medical information
  • health professions education
  • graduate medical education

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  • Competing interests None.

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

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