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Patient safety superheroes in training: using a comic book to teach patient safety to residents
  1. Theresa Camille Maatman1,
  2. Heather Prigmore1,2,
  3. Joni Strom Williams1,2,
  4. Kathlyn E Fletcher1,3
  1. 1 Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
  2. 2 Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
  3. 3 Internal Medicine, Clement J Zablocki VAMC, Milwaukee, Wisconsin, USA
  1. Correspondence to Dr Theresa Camille Maatman, Internal Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA; tmaatman{at}


Problem Medical errors are a health burden. Residents must be aware of patient safety threats and have confidence reporting concerns. Creative modalities for teaching such content (eg, simulation) are resource intensive, while lectures do not assimilate clinical practice. Therefore, the objective of this project was to assess the use of a comic book to train Internal Medicine residents to identify patient safety issues. We report acceptability of the teaching tool and awareness and confidence in identifying patient safety issues using a comic book.

Approach Residents from the Medical College of Wisconsin participated in a 1-hour session to identify 24 safety topics in a comic book. The primary outcomes were awareness and confidence. Engagement and enjoyment were also measured as forms of acceptability of the tool. Comparisons were made using Fisher’s exact tests and paired t-tests for awareness questions and Fisher’s exact tests for confidence questions. Analyses were performed using SAS V.9.4.

Outcomes Fifty participants were included in the analyses. Proportions in each awareness category were significantly different on post-test in 21 of 24 topics included. The confidence in both identifying safety topics (55.1% precourse to 96% postcourse) and reporting them (35.42%–90%) increased significantly after the curriculum. 90% found the tool enjoyable and 98% found the tool engaging.

Next steps This curriculum was successful in increasing resident awareness and confidence regarding patient safety. The use of a comic book was acceptable to residents. Future directions include digital conversion of the curriculum and expansion to include multiple settings within the hospital.

  • patient safety
  • medical education
  • hospital medicine

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  • Contributors TCM drafted the comic book. TCM and KEF designed the study. HP acquired and analysed the data. TM and HP developed the analyses, and TCM, HP, JSW, and KEF interpreted the data. TCM, HP, JSW and KEF critically revised the manuscript for important intellectual content. All authors approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The course evaluation was approved by the MCW Institutional Review Board.

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