Medical Errors & Patient Safety

"Communicating About Medical Errors"

A Curriculum for Students and Residents

Department of Family Medicine

New York Medical College

Overview

Since the 2000-2001 academic year, every third year student at New York Medical College, during their required four-week Family Medicine Clerkship, participates in an innovative curriculum on "Communicating About Medical Errors." This is a four-hour curriculum that consists of a small group discussion, required readings, and a unique videotape exercise with feedback. A didactic presentation during the orientation to the Family Medicine Clerkship reviews the findings of the Institute of Medicine's report, common physician reactions to making errors, recommended approaches to disclosing errors, and the epidemiology of errors in medicine. This material, and a review of a published case of an infant death from an incorrectly calculated drug overdose, is discussed in groups of 12-18 students. Readings on patient safety and medical error are a required part of the clerkship.

The core of the curriculum is an opportunity for each student to participate in a videotaped patient simulation where an error is acknowledged and discussed with a patient. After a brief practice session, each student is videotaped telling a patient-actor that the student had made an error in the patient's care on a previous visit. Immediately after the videotaping, the four students, the standardized patients, a Family Medicine physician, and the behavioral science faculty, review the tapes and provide feedback to the students. The students are provided with a written evaluation from the standardized patient. Each student completes a pre and post self-evaluation on their knowledge of communicating about medical errors and a final overall evaluation of the curriculum. A six-month follow-up survey is also conducted on the students' experience of error in medicine since the clerkship. The Family Medicine Clerkship provides this curriculum to approximately 190 students annually.

The Department has developed a curriculum, Teaching about Medical Errors and Patient Safety*. The results of the first two years of the curriculum are described in the following paper:

Halbach, Joseph L. and Sullivan, Laurie. Patient Safety Education: Evaluation of a required Medical School Curriculum. Academic Medicine. 2005; 80: 600-606.

* This document is MedEdPortal - Peer Reviewed.  Click on the logo for more information.