의과대학생을 위한 환자안전 교육의 국제적 동향 및 국내 현황
Patient Safety Education for Medical Students: Global Trends and Korea’s Status
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초록
This study is a narrative review introducing global trends in patient safety education within medical schools and exploring the status of Korean education. Core competences for patient safety include patient centeredness, teamwork, evidence- and information-based practice, quality improvement, addressing medical errors, managing human factors and system complexity, and patient safety knowledge and responsibility. According to a Korean report addressing the role of doctors, patient safety was described as a subcategory of clinical care. Doctors’ roles in patient safety included taking precautions, educating patients about the side effects of drugs, and implementing rapid treatment and appropriate follow-up when patient safety is compromised. The Korean Association of Medical Colleges suggested patient safety competence as one of eight essential human and society-centered learning outcomes. They included appropriate attitude and knowledge, human factors, a systematic approach, teamwork skills, engaging with patients and carers, and dealing with common errors. Four Korean medical schools reported integration of a patient safety course in their preclinical curriculum. Studies have shown that students experience difficulty in reporting medical errors because of hierarchical culture. It seems that patient safety is considered in a narrow sense and its education is limited in Korea. Patient safety is not a topic for dealing with only adverse events, but a science to prevent and detect early system failure. Patient safety emphasizes patient perspectives, so it has a different paradigm of medical ethics and professionalism, which have doctor-centered perspectives. Medical educators in Korea should understand patient safety concepts to implement patient safety curriculum. Further research should be done on communication in hierarchical culture and patient safety education during clerkship.
Abstract
This study is a narrative review introducing global trends in patient safety education within medical schools and exploring the status of Korean education. Core competences for patient safety include patient centeredness, teamwork, evidence- and information-based practice, quality improvement, addressing medical errors, managing human factors and system complexity, and patient safety knowledge and responsibility. According to a Korean report addressing the role of doctors, patient safety was described as a subcategory of clinical care. Doctors’ roles in patient safety included taking precautions, educating patients about the side effects of drugs, and implementing rapid treatment and appropriate follow-up when patient safety is compromised. The Korean Association of Medical Colleges suggested patient safety competence as one of eight essential human and society-centered learning outcomes. They included appropriate attitude and knowledge, human factors, a systematic approach, teamwork skills, engaging with patients and carers, and dealing with common errors. Four Korean medical schools reported integration of a patient safety course in their preclinical curriculum. Studies have shown that students experience difficulty in reporting medical errors because of hierarchical culture. It seems that patient safety is considered in a narrow sense and its education is limited in Korea. Patient safety is not a topic for dealing with only adverse events, but a science to prevent and detect early system failure. Patient safety emphasizes patient perspectives, so it has a different paradigm of medical ethics and professionalism, which have doctor-centered perspectives. Medical educators in Korea should understand patient safety concepts to implement patient safety curriculum. Further research should be done on communication in hierarchical culture and patient safety education during clerkship.
참고문헌 (32)
- Kohn LT, "To err is human: building a safer health system" (2000), National Academy Press
- Brennan TA, "Incidence of adverse events and negligence in hospitalized patients : results of the Harvard Medical Practice Study I", N Engl J Med, 324(6), pp.370~376 (1991)
- Leape LL, "The nature of adverse events in hospitalized patients : results of the Harvard Medical Practice Study II", N Engl J Med, 324(6), pp.377~384 (1991)
- Gallagher TH, "Patients’ and physicians’ attitudes regarding the disclosure of medical errors", JAMA, 289(8), pp.1001~1007 (2003)
- Burroughs TE, "Patients’ concerns about medical errors during hospitalization", Jt Comm J Qual Patient Saf, 33(1), pp.5~14 (2007)
- 이영미, "환자안전 의학교육과정", Korean Journal of Medical Education, 21(3), pp.217~228 (2009), 한국의학교육학회
- Greiner AC, "Health professions education: a bridge to quality" (2003), National Academy Press
- Goode LD, "When is “good enough?”: the role and responsibility of physicians to improve patient safety", Acad Med, 77(10), pp.947~952 (2002)
- Kachalia A, "The incorporation of patient safety into board certification examinations", Acad Med, 81(4), pp.317~325 (2006)
- "Patient safety and graduate medical education" (2003)[URL]
- Sandars J, "Educating undergraduate medical students about patient safety : priority areas for curriculum development", Med Teach, 29(1), pp.60~61 (2007)
- Donaldson LJ, "The WHO World Alliance for Patient Safety: towards the years of living less dangerously", Med J Aust, 184(10 Suppl), pp.S69~S72 (2006)
- "WHO patient safety curriculum guide for medical schools" (2009)[URL]
- Myung SJ, "The patient safety curriculum for undergraduate medical students as a first step toward improving patient safety", J Surg Educ, 69(5), pp.659~664 (2012)
- Lee HY, "Medical students’ perceptions and intentions regarding patient safety", Qual Improv Health Care, 24(1), pp.23~29 (2018)
- 노혜린, "환자 안전을 위한 진료 능력 성취도에 대한 학생 인식", Korean Journal of Medical Education, 19(3), pp.207~214 (2007), 한국의학교육학회
- 이수현, "의료오류(Medical Error) 공개에 대한 의학전문대학원생과 인턴의 인식 및 태도 비교", Korean Journal of Medical Education, 24(3), pp.247~258 (2012), 한국의학교육학회[DOI]
- Roh H, "Patient safety education to change medical students’ attitudes and sense of responsibility", Med Teach, 37(10), pp.908~914 (2015)
- 안덕선, "한국의 의사상: 좋은 의사양성", 의학교육논단, 16(3), pp.119~125 (2014), 연세대학교 의과대학
- Korean Association of Medical Colleges, "Learning outcomes of basic medical education: human and society-centered" (2017), Gabyumunhwasa
- 노혜린, "의료과오 사례를 이용한 환자안전 교육", Korean Journal of Medical Education, 20(3), pp.265~271 (2008), 한국의학교육학회
- 노혜린, "외과실습에서 의료 오류 예방 및 관리 능력 개발을 위한 환자안전교육의 효과", Korean Journal of Medical Education, 22(4), pp.303~311 (2010), 한국의학교육학회
- 이승희, "환자안전 교육과정 개발 사례 연구", 의학교육논단, 15(3), pp.151~158 (2013), 연세대학교 의과대학
- Seiden SC, "Role of medical students in preventing patient harm and enhancing patient safety", Qual Saf Health Care, 15(4), pp.272~276 (2006)
- "National patient safety education framework" (2005)[URL]
- Mayer D, "Designing a patient safety undergraduate medical curriculum:the Telluride Interdisciplinary Roundtable experience", Teach Learn Med, 21(1), pp.52~58 (2009)
- Korean Medical Association, "Korean doctor’s role" (2014), Korean Medical Association
- Walton M, "Republished paper: the WHO patient safety curriculum guide for medical schools", Postgrad Med J, 87(1026), pp.317~321 (2011)
- Walton M, "Do no harm: is it time to rethink the Hippocratic Oath?", Med Educ, 48(1), pp.17~27 (2014)
- Hall LW, "Effectiveness of patient safety training in equipping medical students to recognise safety hazards and propose robust interventions", Qual Saf Health Care, 19(1), pp.3~8 (2010)
- Martinez W, "Medical students’ experiences with medical errors : an analysis of medical student essays", Med Educ, 42(7), pp.733~741 (2008)
- Walton MM, "Hierarchies : the Berlin Wall of patient safety", Qual Saf Health Care, 15(4), pp.229~230 (2006)