**3. Healthcare professional needs**

There are many involuntary but preventable adverse events that affect patients and may lead to temporary or permanent harms, including increased admission duration, or even causing the death of patients. These harms are most probably related to health care management system failure regardless of the competencies of the healthcare professionals. They also affect the general people and cause economic problem in both developed and developing countries. These events include diagnostic errors, medication errors, postoperative infections and complications, miscommunication, lack of personal and other identities. The problem may be higher in the developing countries because of the poorer infrastructure and lack of financial resources compared to developed countries [1, 2]. We should know that 80% of these events are system driven rather than individual mistakes. So, in order to reduce these adverse events, there is a need to implement a program incorporated in the healthcare system. This program requires the individual commitment towards patient safety rather than financial resources. We need to foster the culture of patient safety and this in turn will reduce the occurrence and

Patient safety is about reducing the risk of unintentional but preventable harm related to health care system to an acceptable minimum. Patient safety is an attribute of the health care system as well as its relation to the physician skills. To develop a curriculum for patient safety, we must consider the complexity of healthcare system and the involvement of many individuals in the delivery of health services. Nowadays, patient safety is considered as a discipline that applies the safety measures and increases the effectiveness of health care system [3].

Necessary steps are to be followed while developing patient safety curriculum. Identification of the problem and the rationale for implementing such curricula is the first step. Then, assessing the needs of healthcare professionals and formulating objectives and selecting the appropriate content and instruction methods according to these needs are the next steps. Evaluating the implemented curriculum is then conducted for improving the process and

**2. Problem and rationale for implementing patient safety curriculum**

Hospitalized patients may be affected by adverse effects. Meanwhile, patients on drugs could be harmed from side effects. Health professions education students should know how to deal with these harms. They should also know the outcomes of miscommunication [4]. Therefore, patient safety is one of human rights issues and a major health problem [1]. In the developed countries one of 10 hospitalized patients is harmed while in the developing countries the rate is higher than that in the industrial countries. A high percentage of these adverse events, reaches 83%, were preventable, while 30% caused the death of the patient [1]. The cost of additional hospitalization, legal actions, infection acquired in hospitals, and disabilities, is estimated in some countries between US \$ 6 billion and US \$ 29 billion in a year. So, there is a growing attention to the income benefits from improving patient safety [5]. Additionally, international accreditation guidelines and standards recommend teaching and learning skills related to patient safety [6].

taking actions and decisions regarding the other steps.

impact of harms.

90 Vignettes in Patient Safety - Volume 3

Medical educators are interested in introducing patient safety in medical programs, on the other side, there is a little training of the undergraduates' students regarding this topic [11].

Inadequate training and the failure of the clinicians and the assistant staff to follow guidelines and protocols contributed to the adverse events [1]. Students' needs should be assessed concerning the topics to be included in patient safety curricula. The goal-directed patient safety curriculum leads to an opened culture and improving the satisfaction of both patients and students [12].

Many factors contributed to this deficiency of training of the healthcare professionals such as: low recognition by the health professions institutions that integrating the principles of the patient safety in their curriculum is important, lack of familiarity and reluctance of the educators to teach these principles, emphasis of educating treatment rather than prevention of the disease and the perceived role of the teachers as only information provider or an expert [13].

Moreover, educational interventions for the healthcare students proved to enhance the prescription of the medications and the adherence to the guidelines by the physicians [14] .

The target learners' needs differ from one context to another. Previous training and experiences relevant to curriculum, existing proficiency and perceived deficiency of the learners should be assessed to adjust the suitable course. The preferences regarding different learning strategies and resources available to the learners help to conduct a learner-oriented course. Formulating the rational and assessing the needs of the healthcare professionals are essential steps for formulating objectives and identification of the course content.

**II. The Canadian Framework (The safety competencies – Enhancing patient safety across** 

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This framework is an inter-professional, and it includes six domains which are as follow: contribute to a culture of patient safety; Work in teams for patient safety; Communicate effectively for patient safety; Mange safety risks; Optimize human and environmental factors; Recognize, respond to and disclose adverse events [2]. Each domain contains the needed

a. Theory of profound knowledge b. Model for improvement c. Quality improvement as

a. From stable delivery model to adaptability and growth within an organization. b. Principles and difference of adaptive versus technical changes. c. Building a compiling case for change. d. Developing a shared vision. e. Sponsorship, champions, alignment and

a. Data, variation, reporting b. Measure for improvement versus research and judgment

World Health Organization provided a Multi-Professions Edition of Patient Safety Curriculum Guide to assist the health professions institutions in implementing the curriculum of patient safety. The guide includes some suggested topics, teaching, and evaluation methods for preparing students who have the knowledge, skills, and attitude for improving their clinical practice and patient safety. Each institution after performing a needs assessment, could integrate these topics into its curriculum. A medical guide was produced by the WHO in 2009; the multi-professional edition was developed after consulting dentists, nurses, midwives, and pharmacists. The guide is divided into two sections: part A: Teacher Guide; and part B: patient Safety Topics. The Teacher Guide helps to build the capacity of the educators. It offers information about the efficient instructional methods to teach the topics and suggested techniques for integrating the module into the existing curriculum. The patient safety topics

The guide covers 11 topics and includes 16 subtopics which were selected from the Australian

**the health professions)**

knowledge, skills, and attitude.

**III. Scottish Patient Safety Fellowship**

**2.** Leading clinician through change.

**3.** Measurement for improvement.

feedback f. compacts

**1.** Improvement theory, methods and tools

It includes six topics and general aims to be fulfilled.

core business strategy d. Planned experimentation.

**4.** Communication, presentations and marketing skills.

**6.** Working with people, motivation, team building [15].

are suggested to be implemented as parts or as a whole [4].

framework. The 11 WHO topics are shown in **Table 1**.

**5.** Reliability theory, system, design for safety.

**IV. WHO patient safety curriculum guide**
