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Patients and families as teachers: a mixed methods assessment of a collaborative learning model for medical error disclosure and prevention
  1. Thorsten Langer1,2,
  2. William Martinez3,
  3. David M Browning1,
  4. Pamela Varrin1,
  5. Barbara Sarnoff Lee4,
  6. Sigall K Bell1,5
  1. 1Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Boston, Massachusetts, USA
  2. 2Department for Neuropediatrics and Muscular Disorders, Universitätsklinikum Freiburg, Freiburg, Germany
  3. 3Division of General Internal Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  4. 4Department of Social Work, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  5. 5Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  1. Correspondence to Dr Thorsten Langer, Department for Neuropediatrics and Muscular Diseases, Center for Pediatrics and Adolescent Medicine, University Medical Center Freiburg, 79106 Freiburg, Germany; thorsten.langer{at}


Background Despite growing interest in engaging patients and families (P/F) in patient safety education, little is known about how P/F can best contribute. We assessed the feasibility and acceptability of a patient–teacher medical error disclosure and prevention training model.

Methods We developed an educational intervention bringing together interprofessional clinicians with P/F from hospital advisory councils to discuss error disclosure and prevention. Patient focus groups and orientation sessions informed curriculum and assessment design. A pre-post survey with qualitative and quantitative questions was used to assess P/F and clinician experiences and attitudes about collaborative safety education including participant hopes, fears, perceived value of learning experience and challenges. Responses to open-ended questions were coded according to principles of content analysis.

Results P/F and clinicians hoped to learn about each other's perspectives, communication skills and patient empowerment strategies. Before the intervention, both groups worried about power dynamics dampening effective interaction. Clinicians worried that P/F would learn about their fallibility, while P/F were concerned about clinicians’ jargon and defensive posturing. Following workshops, clinicians valued patients’ direct feedback, communication strategies for error disclosure and a ‘real’ learning experience. P/F appreciated clinicians’ accountability, and insights into how medical errors affect clinicians. Half of participants found nothing challenging, the remainder clinicians cited emotions and enormity of ‘culture change’, while P/F commented on medical jargon and desire for more time. Patients and clinicians found the experience valuable. Recommendations about how to develop a patient–teacher programme in patient safety are provided.

Conclusions An educational paradigm that includes patients as teachers and collaborative learners with clinicians in patient safety is feasible, valued by clinicians and P/F and promising for P/F-centred medical error disclosure and prevention training.

  • Safety culture
  • Health professions education
  • Patient-centred care
  • Patient education
  • Simulation
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