Training and Education Overview

PSNet offers an unparalleled set of resources for patient safety training and education. In this section, you will have the opportunity to read WebM&M (Morbidity & Mortality) Spotlight Cases and complete the interactive learning modules for free continuing medical education (CME) and maintenance of certification (MOC) credit. You will also be able to search the PSNet Training Catalog, updated monthly with in-person and online training programs, events, and meetings.

Continuing Education: New Spotlight Cases

Spotlight Case and Commentaries are certified for continuing education through two organizations: University of California, Davis (UCD) or University of California, San Francisco (UCSF). Spotlight Case and Commentaries published in November 2019 or later are certified for continuing education through the UCD Health Office of Continuing Medical Education, and any Cases and Commentaries published prior to that date are certified for continuing education through UCSF.

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Spotlight Case

CE/MOC

New

Agitated Delirium Contributes to Missed Testing and Delayed Diagnosis of Gastric Perforation

Jonathan Trask, RN, Kathleen M. Carlsen, PA, Brooks T. Kuhn, MD | March 15, 2023

A 72-year-old man was diagnosed with COVID-19 pneumonia and ileus, and admitted to a specialized COVID care unit. A nasogastric tube (NGT) was placed, supplemental oxygen was provided, and oral feedings were... Read More

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Spotlight Case

CE/MOC

Overdose of Gabapentin and Oxycodone in a Patient with End-Stage Renal Disease: A Case for Appropriate Interruptive Drug-Disease Alerts.

Craig Keenan, MD, Scott MacDonald, MD, Ashley Takeshita, and Dale Sapell, PharmD | February 1, 2023

A 38-year-old man with end-stage renal disease (ESRD) on chronic hemodialysis was admitted for nonhealing, infected lower leg wounds and underwent a below-knee... Read More

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WebM&M Case Studies

WebM&M (Morbidity & Mortality Rounds on the Web) features expert analysis of medical errors reported anonymously by our readers. Spotlight Cases include interactive learning modules available for CME (Continuing Medical Education). Commentaries are written by patient safety experts and published monthly. You can contribute by submitting a case study anonymously.

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New

Sepsis Resulting from Delays in Treatment and Miscommunication among Specialists

Lucy Shi, MD and Erik Noren MD, MS | March 15, 2023

A 71-year-old man presented to his physician with rectal bleeding and pain, which was attributed to radiation proctitis following therapy for adenocarcinoma of the prostate. He subsequently developed a potentially life... Read More

New

Distraction of the Anesthesiologist and Lack of Resuscitation Drugs Resulting in Delayed Treatment of Laryngospasm.

Christian Bohringer, MD | March 15, 2023

A 48-year-old woman was placed under general anesthesia with a laryngeal mask. The anesthesiologist was distracted briefly to sign for opioid drugs in a register, and during this time,... Read More

Have you encountered medical errors or patient safety issues?

Have you encountered medical errors or patient safety issues? Submit your case below to help the medical community and to prevent similar errors in the future.

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Training Catalog

The AHRQ PSNet Training Catalog is an easy to use resource for healthcare professionals across all settings of care and specialties looking for education opportunities to further their knowledge of patient safety practices and principles. Some training opportunities are available as in-person meetings while others are conducted via live or archived webinar. Opportunities are updated on a monthly basis and can be searched by critical fields such as event location, fee, and CE/CME availability. Opportunities are national in scope and identified from not for profit organizations, academic institutions, government agencies, and member associations.

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