Simulation-based training allows learners to learn and practice technical and non-technical skills in a low-risk environment. This review examines the effect of high-fidelity simulation (HFS) on clinical reasoning in nursing students. Results suggest HFS does improve clinical reasoning, but the included studies typically did not directly link improved clinical reasoning to improved patient safety.

Error management training (EMT) encourages learners to make errors during training, and then engage in positive discussions about recognition of those errors. This commentary calls for increased use of EMT for surgical students and residents to promote error recovery.

Efforts to embed patient safety content into defined post-graduate medical curriculum face challenges due to time, culture, and program resource demands. This statement provides detailed safety and quality content recommendations for maternal-fetal medicine fellows that focus on topics such as safety culture, event reporting, and disparities.

Prehospital medication administration for pediatric patients is complicated by the need to obtain an accurate weight for correct dosing. This retrospective analysis examined prehospital medication dosing in children 12 years of age and younger after implementation of a statewide emergency medical services (EMS) pediatric dosing reference. Despite implementation of written guidelines, researchers found that 35% of prehospital medication administrations involved a dosing error. Dosing errors were most common for hyperglycemia reversal medications, opioids, and one type of bronchodilator (Ipratropium bromide).

Learning from mistakes is an essential component of medical and nursing education. This retrospective study examined medical errors and near-misses committed by nursing students at more than 200 prelicensure programs. Of the 1,042 errors and near-misses reported, medication errors were most common (59%). Three primary contributing factors to errors and near-miss events were identified – (1) not checking patient identification, (2) not checking a patient’s allergy status, and (3) not following the “rights” of medication administration.

Medication errors are common, especially among medical trainees. This retrospective cohort study conducted at one medical center in the Netherlands identified a high rate of errors in prescriptions written by medical students (40% of all prescriptions). The most common type of error was inadequate information in the prescription – such as not indicating the dosage form or concentration, or missing usage instructions, or omitting the weight for a pediatric patient. Findings indicate that 29% of errors would not have been intercepted and resolved by an electronic prescribing system or pharmacist.

The Accreditation Council for Graduate Medical Education (ACGME) encourages graduate and undergraduate medical education programs to include the Quality Improvement and Patient Safety (QIPS) curriculum. This review summarizes the status of QIPS programs in the United States. Program length varied widely, from two simulation-based sessions to a two-year QIPS fellowship. Only a quarter of programs used a standardized, validated QIPS evaluation tool, and resident satisfaction and information retention was mixed.

The redeployment of clinicians at the beginning of the COVID-19 public health emergency necessitated rapid training of staff, particularly those assigned to the intensive care unit (ICU). This review identified effective in-situ simulations that could be used in ICUs to restore and sustain patient safety following the COVID-19 pandemic. The in-situ simulations were able to detect latent safety threats and improve patient safety culture, interprofessional communication, and system organization.

As part of clinical learning, residents and trainees are sometimes allowed to make supervised mistakes when patient safety is not at risk. In this study, pediatric hospitalists describe potential benefits and risks of allowing failure, the process of allowing or interrupting failure, and how they decide to allow failure to happen. Consistent with previous research, patient, trainee, team, and institutional factors were identified. Additionally, caregiver/parent factors were noted.

Medical students do not always feel competent when it comes to patient safety concepts. In this study of German medical students, most understood the importance of patient safety, though few could identify concrete patient safety topics, such as near miss events or conditions that contribute to errors. Incorporating patient safety formally into medical education could improve students’ competence in these concepts.

Black patients who experience racism from their providers report receiving lower quality of care. Black public health students were asked about racist behaviors exhibited by their healthcare providers and the impacts the behaviors had on their care. The students recommend education and accountability to reduce providers’ racist attitudes, as well as increasing the number of Black clinicians.  

Clinical reasoning is now a common method to improve diagnostic decision making, and several tools have been developed to assess learners’ clinical reasoning. In this study, hospital faculty and pediatric interns used the Assessment of Reasoning Tool (ART) to assess, teach, and guide feedback on the interns’ clinical reasoning. Faculty and interns report the ART framework was highly structured, specific, formative, and facilitated goal setting.

Racism exacerbates health disparities and threatens patient safety. This article summarizes the relationship between structural racism and health disparities in the United States and highlights how racism impacts health care delivery and health outcomes for patients with sickle cell disease.