TY - JOUR T1 - Impact of medical education on patient safety: finding the signal through the noise JF - BMJ Quality & Safety JO - BMJ Qual Saf SP - 61 LP - 64 DO - 10.1136/bmjqs-2022-015054 VL - 32 IS - 2 AU - Jasmine Hwang AU - Rachel Kelz Y1 - 2023/02/01 UR - http://qualitysafety.bmj.com/content/32/2/61.abstract N2 - Medical education and patient care are inextricably linked. At this time, with the limitations of simulation training and our continued dependence on educated physicians for clinical decision-making, one domain cannot exist without the other. The involvement of medical trainees in patient care means it is vital that the impact of changes to medical training programmes on patient outcomes are assessed with well-designed studies. The study, “National improvements in resident physician-reported patient safety after limiting first-year resident physicians’ extended duration work shifts,”1 by Weaver and colleagues published in this month’s issue of BMJ Quality and Safety signals the need for a robust discussion of education policy research within the field of medicine.Before specifically addressing the approach used by Weaver et al,1 a review of the complexities involved in studying the impact of medical education policy is warranted.2 The field of ‘education outcomes research’ examines the impact to patients of changes to the educational process and clinical learning environment. As with all robust research, studies must be designed to answer a specific question. Typically, this necessitates an explicit definition of the exposure and outcomes to be examined. The exposures under investigation such as the change in education policy evaluated by Weaver et al are often straightforward, but the outcomes are frequently complex. For example, changes to education policy may influence the care delivered by trainees immediately or years later depending on the nature of the change. A further challenge to a well-conceived education outcomes study is the selection of the outcome measure to be evaluated. Ideally, studies on the impact of patient safety should focus on an objective outcome measure rather than a proxy. However, this may not always be feasible. Finally, changes to education policy or practice are not made in isolation. There are usually multiple … ER -