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ANNOTATED BIBLIOGRAPHY

Running head: ANNOTATED BIBLIOGRAPHY

An Annotated Bibliography of Research Related to a

Patient Safety Curriculum

Jennifer Olszewski

Drexel University

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Abstract

Ensuring patient safety and positive outcomes is a priority in healthcare, which requires

leadership on multiple levels. Nursing educators are now challenged to create innovative

curricular changes to enhance clinical judgment and develop leadership skills in nursing students

in an effort to prepare future nurses to act as leaders to ensure positive patient outcomes. This

annotated bibliography summarizes key research related to developing a patient safety

curriculum. Twenty-five references have been critically analyzed for their possible contribution

to a future research project examining and exploring a patient safety curriculum.

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Introduction

In response to the imperative to create a culture of safety, Drexel University has decided

to adopt the Toyota Production System (TPS) into the curriculum to promote patient safety.

Therefore, the purpose of the proposed research is to investigate if exposure to this new TPS

curriculum affects the students’ leadership clinical judgment abilities in High Fidelity Simulation

(HFS). With that, a thorough examination of the literature regarding patient safety education for

all health professionals, particularly nurses, was completed. The need to develop a standardized

curriculum was supported in both the medical and nursing literature. Much of the research relies

on self-reported data, without documentation of the affect the various educational programs have

had on the participants’ ability to practice and promote patient safety. This proposed research

will examine and explore the influence of a patient safety curriculum on nursing student’s

clinical judgment ability during a simulation This research has the potential to impact patient

safety.

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Patient Safety Curriculum

Annotated Bibliography

Ardizzone, L.A., Enlow, W.M., Evanina, E.Y., Schnall, R., & Currie, L. (2009). Impact of

a patient safety curriculum for nurse anesthesia students. Journal of Nursing Education,

48 (12), 706-715.

Nursing faculty at Columbia University, aimed to examine if a patient safety curriculum

impacted senior nurse anesthesia students’ attitudes, knowledge and skills related to patient

safety. Quantitative data was collected from twenty-seven participants in a pretest-posttest

design utilizing a self-made survey to examine students’ attitudes about errors, self-reported

competency related to error-reporting, and knowledge related to a patient safety culture. The

results did not yield a statistically significant difference in the test means. The authors attribute

this to students’ exposure to patient safety in clinical settings. Additionally, the psychometric

analysis (Cronbach’s alpha), which was performed simultaneously with the data collection,

revealed a lack of internal consistency (IC) regarding the attitudes domain, with marginal IC

related to the knowledge and competency domains, resulting in a significant limitation of this

study. Additional limitations include small sample size and self-reported data only. The authors

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also mention the lack of experiential learning as a limitation. Bambini & Perkins (2009), utilized

simulation as their curricular approach which yield improved confidence and efficacy.

Ardizzone et al. (2009) will support the need for a standardized patient safety curriculum with

data that triangulates participants’ self-perceived knowledge, ability and attitude.

Bambini, D., Washburn, J., & Perkins, R. (2009). Outcomes of clinical simulation for

Novice nursing students: Communication, confidence and clinical judgment. Nursing

Education Perspectives, 30 (2), 79-82.

Nursing educators from Grand Valley State University, hypothesized that a three-hour

simulation as a pedagogical approach would increase nursing students’ self-efficacy, confidence

and clinical judgment ability. Bambini et al. (2009), utilized a mixed-methods quasi-

experimental design with a pretest, posttest and follow up survey with open-ended questions.

Each instrument collected self-reported data from 112 participants and was self-made by authors

with content validity was established prior to data collection. Results yielded a significant

increase in self-efficacy and confidence scores with specific skills related to the simulation.

Qualitative data corroborated the quantitative results in terms of confidence and self-efficacy.

Limitations of this study included that all data was self-perceived and self-reported lending itself

to social-response bias. Contrary to self-reported data, Lasater (2006) developed a rubric for

faculty to assess student behaviors and responses during simulation. Additionally, the qualitative

data in this study was collected through written responses to open-ended questions, which may

have limited the results. While this research will contribute to my study by supporting the use of

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simulation, my research will collect observational quantitative data utilizing a clinical judgment

rubric (Lasater, 2006) and self-perceptions will be collected through focus group interviews.

Baumberger, M.H. (2005). Cooperative learning and case study: does the combination

improve students’ perception of problem solving and decision making skills? Nurse

Education Today, 25, 238-246.

A nursing faculty member at Widener University, investigated and compared the

effectiveness of cooperative learning and case study teaching methods on the problem-solving

and decision making skills of undergraduate nursing students with a target audience of nurse

educators. This quasi-experimental pretest-posttest design collected data from 123 participants

utilizing two separate valid instruments to examine self-perceptions of their problem-solving and

decision making skill set. After a multivariate analysis of co-variance was performed to

compare means for the control and two experimental groups (coop learning and case study

learning groups), it was concluded that the teaching approaches utilized yielded no effect on

students’ self-perceived problem-solving and decision making skills for the cooperative learning

group. On the contrary, scores for the case study group demonstrated a significant difference.

These findings corroborate with those of Lasater (2009), which include supporting quantitative

and qualitative findings for case studies. Limitations of this study included relying on self-

reported data without mixed methods triangulation. Additionally, this study did not meet power,

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which limits the outcomes and generalizability of the findings. Taking the limitations into

consideration, this study supports the use of case study scenarios for my research.

Chenot, T. M., & Daniel, L.G. (2010). Frameworks for patient safety n the nursing curriculum.

Journal of Nursing Education, 49 (10), 559-568.

Nursing faculty performed an exploratory quantitative study to investigate the current

state of patient safety education and its affects nursing students’ self-awareness and skills and

attitudes regarding patient safety. While Ardizzone et al. (2009) also examined self-reported

attitudes and skills, Chenot et al. (2010) focused on needs assessment approach without

intervention. The researchers surveyed nursing students at seven universities and community

colleges utilizing a valid tool that had been used with medical students. The goal of this

research was to provide recommendations for nurse educators to aid future nurses to function as

safe practitioners. The data collected supports the need for patient safety education

improvement, particularly a focus that is preventative rather than remedial. Limitations of this

research include the utilization of a tool intended for students in a medical school curriculum.

To that end, the tool was also used for various nursing curricula including baccalaureate,

associate, and diploma programs. Again, the research findings support a need for improvement

in patient safety education, however its focus is limited to students’ self-perception and self-

reporting of students. To that end, this data will support the need for my research to improve

patient safety curricula.

Cooper, S., Kinsman, L., Buyks, P., McConnell-Henry, T., Endacott, R., & Scholes, J. (2010).

Managing a deteriorating patient in a simulated environment: nursing students’

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knowledge, skill and situation awareness. Journal of Clinical Nursing, 19, 2309-2318.

Nursing faculty researchers utilized a quantitative approach to examine the ability of 51

senior undergraduate nursing students to identify and respond to a simulated deteriorating

patient. Data collection encompassed questionnaires to examine participant knowledge,

observed performance assessment by expert faculty, and a situation awareness inventory.

Results confirmed that suboptimal care remains a problem as demonstrated by the participants

slow or lack of response in the initial scenario with mild improvement in the second scenario.

As pointed out by Schmid et al. (2007), patient outcomes are directly linked to nurses’ abilities to

recognize trends in patients. The limitations for this study include a lack of control of students’

various clinical experiences, a small sample size without diversity, and data that is limited to

critically ill patients. As my study utilizes similar simulations for measurement, this research

will provide an important supportive aspect. Additionally, although the researchers do not

mention clinical judgment, the variables they measure for align with Lasater’s (2006) clinical

judgment rubric.

Gantt, L.T., & Corbett, R.W. (2010). Using simulation to teach patient safety behaviors in

undergraduate nursing education. Journal of Nursing Education, 49 (1), 48-51.

Nursing faculty integrated patient safety principles into simulation along with a means

for evaluating and grading students. This study explores students’ knowledge and ability to

practice patient safety in a simulation. The researchers developed checklists specific for the

simulations, in which they established inter-rater reliability. While the 194 student participants

did not receive an educational intervention such as Ardizzone et al. (2009) and Halbach and

Sullivan (2005). The results demonstrated an omission of key safety tasks. Like Cooper et al.

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(2006), simulation was utilized to collect data, which revealed underperformance of students.

The researchers for each study examined different variables, Cooper et al. (2006) focused on the

aspects of clinical judgment and Gantt et al. (2010) focused on tasks related to patient safety

such as patient identification. Despite differing variables for measurement, each study supports

the need to develop a patient safety curriculum as well as supporting the use of simulation to

obtain data. Limitations for this study include a small sample of one class of nursing students.

Additionally, inability to suspend belief during the simulation may have affected student

performances. This research demonstrates both the need for a curriculum as well as clinical

judgment development.

Girdley, D., Johnsen, C., & Kwekkeboom, K. (2009). Facilitating a culture of safety and patient-

centered care through use of a clinical assessment tool in undergraduate nursing

education. Journal of Nursing Education, 48 (12), 702-710.

The principle investigator, a nursing faculty member, with funding from the Quality and

Safety Education for Nurses (QSEN) project developed clinical assessment checklists to assist

nursing students in recognizing safety risks. These assessment tools were created for student use

in the clinical setting to create an awareness and increased recognition of patient safety issues.

Student feedback on the checklists was collected at the end of each semester in written format.

The data revealed that the use of the tool increased students’ awareness of safety issues and the

authors concluded that the clinical assessment tool is useful as a teaching strategy. Limitations

of this evaluation included lack of faculty input in creating the safety assessment tools.

Additionally, the authors identified that the researchers had made an assumption regarding

students’ knowledge base of the clinical setting including equipment safety checks. While this

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evaluation provided pertinent information in terms or providing students with aid in assessing

safety, its lack of rigorous research and focus will not be beneficial for my research.

Haffer, A.G. & Raingruber, B.J. (1998). Discovering confidence in clinical reasoning and

critical thinking development in baccalaureate nursing students. Journal of Nursing

Education, 37 (2), 61-69.

Faculty from California State University developed a two credit hour clinical reasoning

course in the final term of the undergraduate-nursing program. The pedagogical approach

included case studies based on actual patient scenarios. The researchers utilized an interpretive

phenomenological investigation to explore how students perceived their developing clinical

reasoning and critical thinking skills. The researchers examined and identified narrative themes

and exemplars through student logs. Themes included an improvement in confidence and

collaboration. An author-identified limitation included the effect of exposure in the clinical

setting on the development of confidence and critical thinking. Additionally, this research

collected qualitative data through writing to a small sample size of 15 students, without a control

group to provide comparison or the use of program knowledge testing as with Baumberger

(2005). The goal of the researchers was to provide their audience, faculty, a greater

understanding of how students experience clinical reasoning and critical thinking. With that,

this study will benefit my research by corroborating the research of both Baumberger (2005) and

Lasater (2009) by demonstrating that the use of patient case studies aids in the development of

clinical judgment.

Halbach, J.L. & Sullivan, L.S. (2005). Teaching medical students about medical errors and

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patient safety: Evaluation of a required curriculum. Academic Medicine, 80(6), 600-606.

Physician researchers aimed to assess a patient safety curriculum focusing on medical

errors with 572 medical students. The curriculum consisted of a brief four hours with a focus

placed on discussion of medical errors with skills and simulation related to reporting a medical

error to a patient. The researchers utilized a quantitative pretest-posttest design. Participants

completed a questionnaire regarding their self-awareness of their strengths and weaknesses prior

to the course and repeated the questionnaire post their simulation experience comprising

delivering the news of medical error to a patient. The results yielded an increase in self-reported

confidence and knowledge of delivering information regarding a medical error to a patient.

Limitations for this study include a single institution focus, a pre-post test design without a

control group, and the data consisting of self-reported information only. While this research

examines the evaluation of a curriculum as it relates to patient safety, its focus comprises

recognition of an error and communicating the error rather than preventing the error. With that,

this study will not benefit my research.

Henneman, E.A., & Cunningham, H. (2005). Using clinical simulation to teach patient safety

in an acute/critical care nursing course. Nurse Educator, 30 (4), 172-177.

Nursing faculty from University of Massachusetts, provided data for nurse educators

from a course evaluation that incorporated simulation as a pedagogical approach to teaching

patient safety. With smaller class sizes, the authors were able to have students participate in three

simulations designed to incorporate patient safety. Evaluation of the course included a mixed

methods design with the use of an instrument including open-ended questions, which were

triangulated with information collected during the debriefing process. Overall, the students

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reported an increase in their confidence and comfort with key safety issues such as collaboration

and communication. Limitations for this evaluation included the author designed research in

which the literature did not mention its content, validity or reliability or their sample size.

Additionally, this data, like various other studies relied on students’ self-reported data

(Ardizzone, et al.,2009; Halbach et al., 2005). While Henneman et al. (2005) report increases in

confidence and comfort in providing safe care, Gantt and Corbett’s (2010) research utilizing

simulation reported students’ inability to practice with key safety principles. For the purpose of

my research, this study can support the use of simulation as a pedagogical approach to increase

confidence in practice.

Jansma, J.D., Wagner, C., & Bijnen, A.B. (2010). Residents’ intentions and actions after

patient safety education. BioMed Central Health Services Research, 10, 350-357.

Physicians in the Netherlands, sought to discover residents’ intentions and actions to

improve patient safety after they received patient safety education. To that end, the authors

investigated the barriers related to change in order to promote safety in acute clinical settings.

Participants included physicians from multiple sites with various practice specialties. Seventy-

one physicians participated in a two-day patient safety curriculum. Qualitative measures were

used to gain insight into personal experiences three months after completing the course. An

inductive theory approach was utilized with open coding. While participants had developed an

action plan to promote patient safety in the practice setting, barriers precluded implementation

of many action plans. A limitation to this study includes data comprising of self-reports only.

Since all data was qualitative, there is a threat to interpretative bias as well. While this study did

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rely on self-reported data, the researchers sought out to ascertain the actual affect of the

curriculum, however this is not a focus of my research.

Lasater, K. (2006). Clinical judgment development: Using simulation to create an assessment

rubric. Journal of Nursing Education, 46 (11), 496-503.

This researcher has completed multiphase research with numerous publications related

the use of simulation to develop clinical judgment. The purpose of this exploratory research

was to develop a rubric that describes levels of performance in clinical judgment in an effort to

assess student responses during simulation. Thirty-one students participated in simulations with

trained faculty raters to perform internal consistency. The rubric evolved during the collection

phase, which may have affected the validity of the findings. Descriptive stats and ANOVA

were used for the quantitative analysis, with the sample size being small, there were no

significant differences among descriptive data and scoring. Qualitative methods included

written observations of the simulations by trained faculty. This initial feedback from faculty

prompted changes to the rubric. Limitations to this study include the evolution of the rubric

during data collection, and the small sample size. This data was collected through student

simulation over a semester, therefore it is possible that students shared experiences about their

simulation, affecting the results. While other studies have utilized simulation, the data has been

self-reported (Bambini, et al., 2009). My research utilizes the Lasater Clinical Judgment (LCJR),

therefore its development and statistical procedures are pertinent to my study.

Lasater, K. (2007). High-fidelity simulation and the development of clinical judgment:

Students’ experiences. Journal of Nursing Education, 46 (6), 269-275.

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In relation to Lasater’s (2007) previous study, this phase of the research focused on the

student perspective of the simulation experiences. While gathering data related to the rubric,

Lasater (2007) included qualitative data gathered from student focus group interviews with 39

undergraduate nursing students to explore the strengths and limitations of high-fidelity

simulation from the student’s perspective. After coding, a thematic analysis revealed the

students’ confidence in their ability to link theory with practice in simulation. Additional themes

included an increased awareness and the desire for more feedback. In terms of awareness,

various researches discussed this in both nursing (Ardizzone, et al., 2009) and medicine

(Halbach, et al., 2005). Limitations include a small sample size and internal threats to validity

with coding and thematic analysis. This data supports the use of simulation as a tool to link

theory with practice, which is a strong aspect of my study in terms of transferring from the

academe to the hospital setting.

Lasater, K., & Nielsen, A. (2009). The influence of concept-based learning activities on

students’clinical judgment development. Journal of Nursing Education, 48 (8), 441-446.

Lasater and Nielson (2009) performed a quasi-experimental mixed methods study to

examine the affect of concept-based learning on students’ development of clinical judgment.

The sample consisted of 13 junior level nursing students. The experimental group was exposed

to concept-based learning in the form of case studies prior to participating in a high-fidelity

simulation. Quantitative data was collected utilizing the Lasater Clinical Judgment Rubric

(LCJR), as discussed in Lasater (2006). A one-way analysis of variance demonstrated a

statistically significant higher score for the experimental group. The primary investigator

collected the qualitative data, video recorded and watch by several researchers for coding and

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identifying themes. Overall, the students stated the case studies provided structure and faculty

involvement/guidance was crucial. As opposed to the previous study by Lasater (2006), there

were no changes made to the LCJR, and inter-rater reliability was demonstrated. Limitations

include a small sample size, potential bias, and students sharing simulation experiences with

those that have not participated. While Baumberger (2005) demonstrated case study

effectiveness, Lasater and Neilson’s (2009), research allows for quantitative data not reliant on

student perception, which increases its corroboration and strength for my study.

McKeon, L.M., Norris, T., Cardell, B., & Britt, T. (2009). Developing patient-centered care

competencies among prelicensure nursing students using simulation. Journal of Nursing

Education, 48 (12), 711-715.

Faculty from the University of Tennessee aimed to compare the effectiveness and

efficiency of computer-based simulation, such as gaming versus traditional manikin-based

simulations. Like, Girdley et al. (2009), the research site was chosen to participate in the QSEN

project. A pretest-posttest case study design was utilized to compare the two types of simulation.

Total sample size was 65 nursing students in an undergraduate pediatric nursing course. All 65

students completed the pre-test and were then split into one of the simulation groups. While

there was an improvement in the over-all patient-centered care competencies, there was no

difference in scores found by simulation interventions. Limitations of this study include a small

sample size and the pretest-posttest design. While this research may provide valuable

information, it does not provide a benefit for my research.

Nei, Y., Lin, L., Chen, P., Barraclough, B., Zhang, M., & Li, J. (2011). Patient safety education

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for undergraduate medical students: A systematic review. BioMed Central Medical

Education, 11 (33), 1-8.

With an aim to identify a successful patient safety educational intervention, the

researchers systematically reviewed studies related to the introduction and implementation of a

patient safety education curriculum for undergraduate medical students. Inclusion criteria

included randomized or non-randomized, pre/post-test or descriptive studies reporting the

outcomes of patient safety curricula on knowledge, skills and attitudes of undergraduate medical

students. Additionally, inclusion criteria also included an intervention with outcome data. The

researchers performed a comprehensive literature search including medical databases. Meta-

analysis was calculated if possible, otherwise a descriptive analysis was completed. The initial

analysis pooled 1481 studies, resulting in a total of seven studies that met the criteria with each

using self-made questionnaires to examine students’ perceptions of their knowledge and

attitudes. Nei et al. (2011) reported that current patient safety curriculum is based on remedy,

not prevention, which is lacking in the current literature. This is demonstrated in Halbach et al.

(2005), with a focus on reporting errors rather than prevention. Limitations include the search

only looked at medical databases. Despite this literature review not including nursing, the lack

of medical research demonstrates a need for an interdisciplinary standardized curriculum with

documented outcomes.

Piscotty, R., Grobbel, C., & Tzeng, H.M. (2011). Integrating quality and safety competencies

into undergraduate nursing using student-designed simulation. Journal of Nursing

Education, 50 (8), 429-435.

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Nursing faculty aimed to study if a student-led simulation was effective in increasing

students’ quality and safety knowledge, skills, and attitudes in six QSEN areas. Two hypotheses

were tested using a quasi-experimental pretest-posttest design: (1) the postiventory mean scores

will be significantly higher than the preinventory scores and (2) the posttest mean scores will be

significantly higher that the pretest scores. A convenience sample of 141 undergraduate nursing

students participated in this study. Two instruments were developed and used. One instrument

or inventory was designed to measure students’ self-rated knowledge, skills and attitudes, . The

second was a multiple-choice test to examine knowledge. The hypothesis regarding students’

self-rated quality, skills and attitudes were supported. On the contrary, the knowledge test was

not supported. While this was not measured in simulation, the findings corroborate with Cooper

et al., (2009) and Gantt et al., (2010). The authors posit this may be secondary to the test’s

reliability, which contributes to a limitation of this study. Further limitation includes using two

separate cohorts of students, a traditional and an accelerated second-degree without a control

group. This study, in combination with the others mentioned, support the need for further

research not reliant on self-reporting.

Richardson, A. & Storr, J. (2010). Patient safety: a literature review on the impact of nursing

empowerment, leadership and collaboration. International Council of Nurses, 57 (1),

12-21.

The authors conducted a meta-analysis to identify the extent that nursing leadership,

collaboration and empowerment can impact patient safety. After a comprehensive search of

electronic databases, eleven studies met the inclusion criteria determined by the researchers.

Analysis revealed that leadership behaviors and styles impact patient safety and outcomes. The

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leadership skills noted among all of the research analyzed included collaboration and teamwork.

A limitations of the research included reviewing papers only in the English language. This

research demonstrates a need for a curriculum that links leadership skills to patient safety, and

will be an asset to my literature review.

Schmid, A., Hoffman, L., & Happ, M.B., (2007). Failure to Rescue: a literature review.

The Journal of Nursing Administration, 37 (4), 188-197.

The authors include nursing faculty and nursing administrators in a hospital setting. The

purpose of their literature review was to enhance nurses executives’’ understanding of failure to

rescue as a nurse outcome. The authors searched multiple medical and nursing databases, which

revealed three streams; failure to rescue as a quality outcome indicator, relationship of failure to

rescue and nurse staffing variables, and the impact of the rapid response team in reducing in-

hospital cardiac arrest and unexpected transfers to the intensive care units. Several studies

document that the greater number of registered nurse hours per day was associated with a lower

failure to rescue rate. A limitation of these data collections includes different methods of

reporting and nurse patient ratios. As Cooper et al., (2010) demonstrated, graduating nursing

students were unable to recognize and intervene appropriately with a deteriorating patient.

While this research does not directly link to my proposed study, the information regarding failure

to rescue is an important aspect. The simulations for my study are failure to rescue cases, which

this research supports.

Stahl, K., Augenstein, J., Schulman, C.I., Wilson, K., McKenney, M., & Livingstone, A.

(2011). Assessing the impact of teaching patient safety principles to medical

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students during surgical clerkships. Journal of Surgical Research, 170 (1), e29-e40.

The researchers from University of Miami hypothesized that students who participated in

a safety curriculum would be knowledgeable regarding patient safety and are more likely to

intervene to avoid patient errors. The researchers developed a two part curriculum with general

safety information during year one of medical school including 110 participants, and specific

surgical safety training during year three which included 67 participants from the original 110

participants. The curriculum consisted of lecture, multiple-choice tests and web-based surveys.

Quantitative data was collected with pretest/posttests exploring students’ perception of safety, as

well as knowledge test scores. Results yielded a higher report of patient safety concerns, which

correlated, with the theoretical knowledge of patient safety principles. Additionally, the students

that participated in both the first and third year had increased self-reported as well as tested

theoretical knowledge. Limitations include the use of self-reported data and exposure to patient

safety in the clinical setting. This research demonstrates that education can be effective,

therefore it will benefit my research.

Thompson, D.A., Cowan, J., Holzmueller, C., Wu. A.W., Bass, E., Pronovost, P. (2008).

Planning and implementing a systems-based patient safety curriculum in medical

education. American Journal of Medicine, 23 (4), 271-277.

The authors consisted of nurse educators and physicians at John Hopkins University. The

purpose of their research was to evaluate the effectiveness of a novel patient safety curriculum

for first-year medical students at Johns Hopkins University School of Medicine. A ten-hour

patient safety elective consisting of lectures, case studies, role-play, video analysis, and

shadowing a nurse was created for all first year medical students. A large focus of the

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curriculum was identifying defects or system problems. The data provided was from course

evaluations, which demonstrated positive feedback. While there are similarities with that of

Halbach et al. (2005) in terms of a medical curriculum, its lack of rigorous research methods will

not benefit my study.

Tregunno, D., Jeffs, L., & Hall, L.M. (2009). Leadership for patient safety and learning in

critical care. The Journal of Nursing Administration, 39 (7/8), 334-339.

The authors used a qualitative approach to explore nursing leadership as it pertains to

patient safety in critical care in an effort to identify areas for improvement to promote positive

patient outcomes. The researchers conducted focus group interviews with providers and

managers within the hospital setting to explore identification of the bedside nurse leaders for

patient safety. Three themes emerged and included; the experienced nurse with situation

awareness and the ability to advocate for their patients. The themes will provide the framework

for developing leadership of nurses within their institution. A limitation of this study includes

collecting data from only one unit in the hospital, which may be biased. The themes identified

align with the Institute of Medicine’s recommendations (2010), and provide data for my

research in terms of leadership skill.

Vaismoradi, M., Salsali, M., & Marck, P. (2011). Patient safety: nursing students’ perspectives

and the role of nursing education to provide safe care. International Nursing Review,

58 (4), 434-441).

Nursing faculty in Iran aimed to explore Iranian nursing students’ perspectives regarding

patient safety and the role of nursing education in developing their ability to provide safe care.

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The methodology included a qualitative study using content analysis approach for data collection

and analysis. Participants included seventeen nursing students in various stages in the

curriculum. Data gathering included face-to-face semi-structured interviews which focused on

participants’’ perspective on patient safety. The results demonstrated that students did not feel

knowledgeable and were dissatisfied with patient safety content. The limitations for this study

included its small sample size with students at various stages in the program. Additionally, the

use of qualitative data limits the findings, bias may have been a factor. This research supports

the need for a global standardized curriculum and will add to my research.

Varkey, P., Karlapudi, S., Rose, S., & Swensen, S. (2009). A patient safety curriculum for

graduate medical education: results from a needs assessment of a needs assessment of

educators and patient safety experts. American Journal of Medical Quality, 24 (3),

214-221.

Physician researchers from the Mayo Clinic performed a needs assessment to aid in the

development of a patient safety curriculum for the graduate medical education programs. The

needs assessment consisted of an institution-wide assessment surveying program directors,

institutional safety experts, and experts in simulation technology. Data was collected through

open-ended questions during interviews. Additionally, ongoing patient safety initiative and

curricula were examined and safety/education experts were identified. This assessment revealed

several concerns regarding inadequate faculty development and role modeling that might

negatively affect or impede patient safety training. The researchers uncovered twenty-one

safety-topics and created themes including; (1) cultural, (2) cognitive, and (3)technical content.

The study participants felt that the experiential learning with simulation currently in their

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programs provided the most effective method to teach and learn. This study provided the means

to develop and implement appropriate patient safety curriculum. Limitations for this study

include a select group of participants with a threat to bias. While the information is valuable and

supports a need for patient safety curriculum in both medicine and nursing, it will not benefit my

research.

Wakefield, A., Attree, M., Braidman, I., Carlisle, C., Johnson, M., & Cooke, H. (2005).

Patient safety: do nursing and medical curricula address this theme? Nurse


Researchers performed a literature review to examine what extent patient safety is

addressed within medical an nursing curricula in the United Kingdom. The literature review of

both medical and nursing journals revealed a low emphasis on patient safety. Limitations of this

study include evaluating the literature in England only and lack of criteria or a selection process

noted. Therefore, secondary to the unknown selection or methodology, it appears this article is

not of a research basis and therefore will not be included in my study.

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References

Ardizzone, L.A., Enlow, W.M., Evanina, E.Y., Schnall, R., & Currie, L. (2009). Impact of

a patient safety curriculum for nurse anesthesia students. Journal of Nursing Education,

48 (12), 706-715.

Bambini, D., Washburn, J., & Perkins, R. (2009). Outcomes of clinical simulation for

Novice nursing students: Communication, confidence and clinical judgment. Nursing

Education Perspectives, 30 (2), 79-82.

Baumberger, M.H. (2005). Cooperative learning and case study: does the combination

improve students’ perception of problem solving and decision making skills? Nurse


Chenot, T. M., & Daniel, L.G. (2010). Frameworks for patient safety n the nursing curriculum.

Journal of Nursing Education, 49 (10), 559-568.

Cooper, S., Kinsman, L., Buyks, P., McConnell-Henry, T., Endacott, R., & Scholes, J. (2010).

Managing a deteriorating patient in a simulated environment: nursing students’

knowledge, skill and situation awareness. Journal of Clinical Nursing, 19, 2309-2318.

Gantt, L.T., & Corbett, R.W. (2010). Using simulation to teach patient safety behaviors in

undergraduate nursing education. Journal of Nursing Education, 49 (1), 48-51.

Girdley, D., Johnsen, C., & Kwekkeboom, K. (2009). Facilitating a culture of safety and patient-

23


centered care through use of a clinical assessment tool in undergraduate nursing

education. Journal of Nursing Education, 48 (12), 702-710.

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