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Journal Article > Commentary
Spear SJ. Harv Bus Rev. September 2005;83:78-91.
This commentary provides a broad overview of the issues facing health care systems in their efforts to promote quality and safety. The author discusses pervasive cultural barriers and process limitations that contribute to errors, while providing a series of anecdotes to demonstrate how easy and frequent these events can occur. Approaches for improvement that draw from the experiences of non-health care organizations, such as Toyota, are included. The strength of the commentary lies in the compelling stories shared and the perspectives offered to foster change.
Journal Article > Study
Patients as teachers: a randomised controlled trial on the use of personal stories of harm to raise awareness of patient safety for doctors in training.
Jha V, Buckley H, Gabe R, et al. BMJ Qual Saf. 2015;24:21-30.
In a 2010 report, patient safety was described as a critical unmet need in medical and nursing education. Formal curricula have emerged, but incorporating these ideals into trainees' practices remains challenging. This randomized controlled trial compared two educational strategies, patient narratives of health-related harm versus traditional faculty-delivered teaching, on the attitudes of physicians-in-training towards patient safety. Using the Attitude to Patient Safety Questionnaire, researchers found no differences in the two groups. Those learners who received patient narrative teaching demonstrated both stronger negative and positive reactions to the curriculum than those receiving traditional instruction. These results suggest that patient narratives alone are unlikely to change trainee physicians' attitudes toward patient safety. A past AHRQ WebM&M perspective discusses the role of graduate medical education in patient safety.