Posted by on Apr 5, 2007 in Teaching Strategies |

Submitter Information

Author: Leslie W. Hall, M.D.
Title: Associate Professor of Clinical Internal Medicine
Institution: University of Missouri – Columbia
Coauthors: Susan Scott, RN, MSN; Patient Safety Coordinator, Univ of Missouri Health Care; Columbia, MO, USA Karen R. Cox, RN, PhD; Manager of Quality/Safety at Univ of Missouri Health Care; Columbia, MO, US

Competency Category(s)
Patient-Centered Care, Quality Improvement, Safety, Teamwork and Collaboration

Learner Level(s)
Pre-Licensure BSN

Learner Setting(s)

Strategy Type
Case Studies

Learning Objectives

At the completion of this four week course, you should be able to
demonstrate the following knowledge and skills in patient safety,
quality improvement and teamwork:

Patient Safety:

  • Define a medical error, adverse event, and near miss
  • Describe typical responses to medical error
  • Describe rationale for standardization of routine procedures and processes
  • Describe contributing factors to medical error
  • Identify root causes, contributing factors and corrective strategies following review of an adverse event

Quality of Care:

  • Identify the six Institute of Medicine aims for quality care
  • Describe and explain basic quality improvement/change concepts o
    Care as a process o Developing an aim statement for an
    improvement project o Collection of baseline and process data
    (numerator and denominator)
  • Describe how both medical and process improvement knowledge are needed for health care improvement
  • Identify and critique the gap between current practice and best practice
  • Demonstrate problem solving on behalf of a known quality gap
  • Generate a process flow map for a given care process
  • Identify aim/goal statement
  • Identify one key measurement to track progress
  • Identify one key measurement to evaluate intervention


  • Describe strengths that various health professions bring to patient
    care, and articulate why and how various health professions must work
    together within a health care team to achieve improvement
  • Describe necessary elements of effective teamwork
  • Describe necessary elements of effective team leaders
  • Identify key interpersonal skills that facilitate effective teamwork
  • Participate in team critique

Strategy Overview

The described curriculum is designed to be used with health
professional students of all types who are brought together to review a
health care incident in which an adverse event occurred. We have used
this curriculum with nursing students (senior undergraduate students in
final semester), second year medical students, second year health
management students, and respiratory therapy students. After one
introductory session, all further work in this curriculum is conducted
in interprofessional small groups. We have typically assigned two
facilitators to each small group (ideally representing two different
health professions); however, this is intended to be student-led problem
based learning, and students are typically given as much control of the
learning process as possible. Working with students of other
professions, learners are asked to analyze the event and determine the
underlying root causes. They are then challenged to propose system
changes that might prevent similar events in the future. They are asked
to analyze the impact of proposed system changes, then choose one of the
changes for additional focus, designing an aim statement and metrics
for a proposed improvement project. At the end of the course, each small
group is asked to summarize their analysis of the assigned case to a
group of their peers (see attached PowerPoint template).

This curriculum has evolved over five years, gradually becoming more
successful. Elements that seem to engender success are: (1)
Problem-based learning format, (2) Minimizing lecture time and
maximizing small group time, (3) Requirement for presentation at the end
of the course, which helps to fully engage students in the process.
Challenges in delivery of this course include scheduling class time when
all learners can be present (requires planning 6 to 12 months in
advance), differences in levels of clinical experience among the
learners, and differing attitudes about patient safety that learners
bring into the sessions.

Submitted Materials

Additional Materials

Interprofessional_Curriculum_in_Patient_Safety_and_Quality.doc (147Kb)
Safety_and_Quality_Attitudes_Survey.doc (101Kb)
Pt_Safety_and_QI_Project_Presentation.ppt (67Kb)

Evaluation Description

Participant attitudes regarding quality, safety and teamwork assessed
for all learner types (nursing, medicine, health management) before and
after completion of the curriculum (see attached file). End of course
evaluations completed by learners. Elements of the curriculum are
included in knowledge-based examination for all involved students.