The World Health Organization Multi-Professional Patient Safety Curriculum: implementation of key modules and its impact on patient safety knowledge, skills, and attitudes of medical students at the University of Algarve

ABSTRACT - Objectives: We attempted to show how the implementation of the key elements of the World Health Organization Patient Safety Curriculum Guide Multi-professional Edition in an undergraduate curriculum affected the knowledge, skills, and attitudes towards patient safety in a graduate entry Portuguese Medical School. Methods: After receiving formal recognition by the WHO as a Complementary Test Site and approval of the organizational ethics committee , the validated pre-course questionnaires measuring the knowledge, skills, and attitudes to patient safety were administered to the 2nd and3rd year students pursuing a four-year course (N = 46). The key modules of the curriculum were implemented over the academic year by employing a variety of learning strategies including expert lecturers, small group problem-based teaching sessions, and Simulation Laboratory sessions. The identical questionnaires were then administered and the impact was measured. The Curriculum Guide was evaluated as a health education tool in this context. Results: A significant number of the respondents, 47 % (n = 22), reported having received some form of prior patient safety training. The effect on Patient Safety Knowledge was assessed by using the percentage of correct pre- and post-course answers to construct 2 × 2 contingency tables and by applying Fishers’ test (two-tailed). No significant differences were detected (p < 0.05). To assess the effect of the intervention on Patient Safety skills and attitudes, the mean and standard deviation were calculated for the pre and post-course responses, and independent samples were subjected to Mann-Whitney’s test. The attitudinal survey indicated a very high baseline incidence of desirable attitudes and skills toward patient safety. Significant changes were detected (p < 0.05) regarding what should happen if an error is made (p = 0.016), the role of healthcare organizations in error reporting (p = 0.006), and the extent of medical error (p = 0.005). Conclusions: The implementation of selected modules of the WHO Patient Safety Curriculum was associated with a number of positive changes regarding patient safety skills and attitudes, with a baseline incidence of highly desirable patient safety attitudes, but no measureable change on the patient safety knowledge, at the University of Algarve Medical School. The significance of these results is discussed along with implications and suggestions for future research.RESUMO - Objetivos: Tentamos demonstrar como a aplicação de elementos-chave da World Health Organization Patient Safety Curriculum Guide Multi-professional Edition no currículo afeta conhecimentos, competências e atitudes em relação à segurança do paciente no curso de Medicina pós-graduado da Universidade do Algarve,Portugal. Métodos: Após reconhecimento formal pela OMS como um Site Complementar e aprovação da comissão de ética organizacional, os questionários pré-curso validados foram administrados ao 2º e 3º ano de um curso de quatro anos (n = 46). Módulos chave do currículo da OMS foram implementadas ao longo do ano letivo utilizando varias de estratégias pedagógicas, incluindo aulas por peritos, sessões de ensino em pequenos grupos baseada em problemas(PBL),tal como sessões de laboratório de simulação seguido por administração de questionários idênticos.O impacto das atividades de aprendizagem foram availadas,tal como a introdução do currículo como ferramenta de aprendizagem neste contexto. Resultados: Um número significativo de inquiridos 47%, (n = 22) relataram algum tipo de formação prévia na área de segurança do paciente. O efeito sobre os Conhecimentos de Segurança do Paciente foram avaliados utilizando a percentagem de respostas certas pré e pós-curso para construir tabelas de contingência 2x2 e aplicando o Teste de Fischers(2 caudas).Não foram detetadas diferenças significativas (P <0,05). Para avaliar o efeito da intervenção em competências e atitudes de Segurança do Paciente, a média e o desvio-padrão foi calculada para as respostas pré e pós-curso, e foi aplicado o teste de Mann-Whitney para amostras independentes. A avaliação de atitudes indicou uma incidência base muito elevada de atitudes desejáveis para a segurança do paciente. Foram detetadas alterações significativas (P