title: A comprehensive collaborative patient safety residency curriculum to address the ACGME core competencies.
abstract: BACKGROUND
  Patient safety currently receives only scant attention in most residency curricula. Safety is a subject that transcends the US Accreditation Council for Graduate Medical Education's 6 core competencies.
  
  
  OBJECTIVE
  To design and implement a new patient safety curriculum in collaboration with the Schools of Nursing and Pharmacy, in such a way as to address all 6 competencies.
  
  
  METHODS
  The curriculum applies to a university-based family medicine residency programme with 45 residents at 5 sites, including urban, suburban and rural sites. CURRICULUM DESIGN: The curriculum includes introductory workshops for faculty and residents, a series of didactic courses, individual portfolios and a series of small group exercises including chart reviews, case presentations and a longitudinal quality improvement project. The activities are run by a multidisciplinary team.
  
  
  METHODS
  Main outcome measures include assessment of resident performance in curriculum activities and in an annual objective structured clinical examination (OSCE) that includes standardised patient interviews, simulations and a written examination. Programme evaluation will include comparison of OSCE performance with that at a neighbouring residency.
  
  
  RESULTS
  Residents identified safety problems and system-based solutions using a safety journal. Cases of polypharmacy were identified using journals and chart reviews, and medication changes proposed and discussed. At resident practice sites, residents identified safety priorities based on a staff survey and proposed system-based solutions. Results of the OSCE will be presented elsewhere.
  
  
  CONCLUSIONS
  A new patient safety curriculum was successfully introduced into a family medicine residency. The curriculum integrates patient safety into residents' daily activities and incorporates input from the disciplines of nursing and pharmacy so as to help build more effective clinical teams and inculcate a culture of safety.
authors.affiliation: Department of Family Medicine, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, New York, USA. rs10@buffalo.edu
authors.forename: Ranjit
authors.initials: R
authors.lastname: Singh
authors.forename: Bruce
authors.initials: B
authors.lastname: Naughton
authors.forename: John S
authors.initials: JS
authors.lastname: Taylor
authors.forename: Marlon R
authors.initials: MR
authors.lastname: Koenigsberg
authors.forename: Diana R
authors.initials: DR
authors.lastname: Anderson
authors.forename: Linda L
authors.initials: LL
authors.lastname: McCausland
authors.forename: Robert G
authors.initials: RG
authors.lastname: Wahler
authors.forename: Amanda
authors.initials: A
authors.lastname: Robinson
authors.forename: Gurdev
authors.initials: G
authors.lastname: Singh
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003479:Curriculum; D005194:Family Practice / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D009518:New York; D012423:Rural Health; D017751:Safety Management; D014504:Urban Health