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Open Access Highly Accessed Research article

Patient safety and quality improvement education: a cross-sectional study of medical students’ preferences and attitudes

Claire L Teigland1*, Rachel C Blasiak1, Lindsay A Wilson12, Rachel E Hines1, Karen L Meyerhoff1 and Anthony J Viera13

Author Affiliations

1 Public Health Leadership Program, Gillings School of Global Public Health; School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

2 Department of Internal Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

3 Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

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BMC Medical Education 2013, 13:16  doi:10.1186/1472-6920-13-16

Published: 5 February 2013



Recent educational initiatives by both the World Health Organization and the American Association of Medical Colleges have endorsed integrating teaching of patient safety and quality improvement (QI) to medical students. Curriculum development should take into account learners’ attitudes and preferences. We surveyed students to assess preferences and attitudes about QI and patient safety education.


An electronic survey was developed through focus groups, literature review, and local expert opinion and distributed via email to all medical students at a single medical school in the spring of 2012.


A greater proportion of students reported previous exposure to patient safety than to quality improvement topics (79% vs. 47%). More than 80% of students thought patient safety was of the same or greater importance than basic science or clinical skills whereas quality improvement was rated as the same or more important by about 70% of students. Students rated real life examples of quality improvement projects and participation in these projects with actual patients as potentially the most helpful (mean scores 4.2/5 and 3.9/5 respectively). For learning about patient safety, real life examples of mistakes were again rated most highly (mean scores 4.5/5 for MD presented mistakes and 4.1/5 for patient presented mistakes). Students rated QI as very important to their future career regardless of intended specialty (mean score 4.5/5).


Teaching of patient safety and quality improvement to medical students will be best received if it is integrated into clinical education rather than solely taught in pre-clinical lectures or through independent computer modules. Students recognize that these topics are important to their careers as future physicians regardless of intended specialty.

Medical education; Quality improvement; Patient safety; Curriculum development