Checklists are increasingly used to support clinical and diagnostic reasoning processes. This study examined the impact of a checklist on electrocardiogram interpretation in 42 first-year general practice residents. Findings indicate that the checklist reduced the time to diagnosis but did not affect accuracy or confidence.

Use of abbreviations in electronic health records increases risk of misunderstandings, particularly between providers of different specialties. In this study, junior doctors and general practitioners were asked about their understanding of common, uncommon, and rare abbreviations used in hospital discharge notes. No abbreviation was interpreted in the same way by all respondents, and nearly all respondents left at least one abbreviation blank or responded that they didn't know.

Racism and implicit biases can threaten the safety of care. The authors in this article outline how implicit bias can affect health professional trainees and impact patient care in obstetrics and gynecology, and outlines strategies to address implicit bias through bias awareness and management curricula, ensuring a supportive learning environment, and faculty development.

Maternal morbidity and mortality are disproportionately experienced by persons of color in the United States. The authors of this article present a socioecological model for understanding the individual, interpersonal, organizational, community, and societal factors contributing to Black maternal morbidity and mortality. The authors outline several recommendations for improving care, including workforce diversification, incorporating social determinants of health and health disparities into health professional education, and exploring the impact of structural racism on maternal health outcomes.  

The Accreditation Council for Graduate Medical Education (ACGME) in the United States limits resident physicians' workweek to 80 hours. Several studies have investigated the association between first year residents (i.e., interns, PGY1), worked hours and patient safety. This study includes residents beyond the first year (i.e., PGY2+). Nearly 5,000 PGY2+ residents reported the number of hours worked, patient safety outcomes, and resident health and outcomes. Working more than 60 hours in a week significantly increased the risk of a medical error resulting in patient death. The authors suggest weekly workweek limits should be significantly reduced, such as they are in the United Kingdom.

The “July effect” is a widely held, yet poorly studied, belief that the quality of care delivered in teaching hospitals decreases during the summer months due to the arrival of new trainee physicians. Using national inpatient stay data from 2018, this study found that the risk of postpartum hemorrhage among patients treated at teaching hospitals was significantly higher during the first six months of the academic year (July to December) compared to the second half (January to June). The authors recommend future research examine whether postpartum hemorrhage is associated with resident work hours, technical deficiencies, or unfamiliarity with hospital practices, and emphasize the importance of monitoring and clinical training to mitigate the impacts of the “July effect.”

Hierarchy based on expertise is appropriate in some situations, but hierarchy based on factors not related to expertise (i.e., gender or discipline) hinders safe patient care. In this study, teams of first-year residents and nurses participating in a training session were recorded on audio and video. Using the status characteristics and expectation states (SCES), transcripts and videos were coded separately by statement type (e.g., directive, question) and gender and discipline. Statement types by gender and status varied slightly between transcript and video, but were largely consistent with expectations, suggesting the SCES framework could be applied to larger teams and studies.

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.

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.

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.

Patient safety improvements must consider the complexities of care delivery to achieve lasting change. This commentary discusses recent evidence examining the effect of duty hour limit adjustments. The authors highlight challenges regarding research design on this medical education policy change and how it affects learner and patient experience. They suggest caution in applying the study conclusions. 

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.