Patient Safety Education in Entry to Practice Pharmacy Programs: A Systematic Review

Abstract

ObjectivesThe aim of this systematic review was to synthesize, summarize, and evaluate the quality of extant quantitative and qualitative literature related to patient safety in pharmacy education. This systematic review included literature that targeted the content, delivery, and outcomes of patient safety in addition to literature that explored the perspectives of pharmacy students and faculty on how patient safety is integrated within their curricula.MethodsA systematic review was conducted. Four electronic databases were searched for articles published between 2000 and 2019: PubMed, MEDLINE, EMBASE, and ScienceDirect. Selection was based on prespecified criteria and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Two independent reviewers selected articles, extracted data, and assessed articles’ qualities using the Crowe Critical Appraisal Tool. Discrepancies were resolved by consensus or by consulting a third reviewer. Descriptive synthesis of data was performed.ResultsTwenty-five eligible articles were included. The majority of studies originated from United States (n = 15). Educational content involved principles of patient safety, and identification, disclosure, and management of medication errors. There was a lack of standardization on how patient safety is incorporated into the pharmacy curricula. Eleven articles (64%) were interprofessional in nature, delivered as a patient safety course (n = 6), through simulation (n = 3), as seminars (n = 1), or as part of student experiential learning (n = 1). Of the 7 articles discussing delivery of patient safety through courses or modules, 4 (57%) were offered as elective courses. Students’ perceptions and attitudes significantly improved after all patient safety interventions, reflecting the importance of addressing patient safety in education to ensure optimum future practice.ConclusionsThis systematic review demonstrated how patient safety education was incorporated into pharmacy programs in terms of the content and methods of delivery. It was promising to see patient safety content being delivered interprofessionally and in experiential education. Students and faculty regarded implementing patient safety in education as an essential act to meet future work demands. Longitudinal studies to assess the long-term impact of incorporating patient safety on student behaviors upon graduation and health outcomes are needed.

Integrating Patient Safety Discussions with First-Year Doctor of Pharmacy Students in a Skills Lab Course

“…These patient safety learning activities were designed to facilitate student reflection on various causes of medication-related errors stemming from prescriptions and how patients are impacted when errors are not caught and generate systems-based strategies for ensuring that those same errors would not continue to recur. Additionally, these learning activities served as a precursor to the required Health Care Systems and Patient Safety course in the following semester to support the purposeful repetition of key curricular content, as suggested by the existing literature [13]. Patient safety content is not explicitly addressed in any other courses in the first semester of the first year.…”

“…There is a lack of standardization regarding how and when patient safety is incorporated into the pharmacy curricula [12][13][14]. Examples in the published literature include standalone courses (both required and elective) [15][16][17][18], simulation-based activities [19,20], practicing the use of tools such as root cause analysis [21,22], application of resources to identify and document medication-related problems on Advanced Pharmacy Practice Experiences [23], and interprofessional activities [24].…”

“…Examples in the published literature include standalone courses (both required and elective) [15][16][17][18], simulation-based activities [19,20], practicing the use of tools such as root cause analysis [21,22], application of resources to identify and document medication-related problems on Advanced Pharmacy Practice Experiences [23], and interprofessional activities [24]. These different approaches to patient safety education have demonstrated effectiveness in areas including improving overall attitudes towards the importance of safety in practice, enhancing patient safety knowledge and skills, and increasing confidence in the ability to address patient safety problems [13,15,16]. Notably, all the examples listed cover a wide range of years in both the didactic and experiential pharmacy curriculum.…”

“…Notably, all the examples listed cover a wide range of years in both the didactic and experiential pharmacy curriculum. Given the variation in approaches to patient safety education, there is an ongoing need to continue developing the literature base and provide examples of different methods that can be used to support patient safety training [12,13,25]. Of note, there is a limited literature (and no recent literature) describing patient safety education for students in their first year of training.…”

“…There may be a perception that students do not have enough clinical knowledge at the beginning of their pharmacy education to fully engage in patient safety learning activities [21]. Regardless of the reason, providing pharmacy students with foundational conceptual knowledge of patient safety principles early on in their training will allow them to apply this knowledge more effectively as their didactic clinical training, experiential training (including Introductory Pharmacy Practice Experiences), and even work experience progresses [13].…”