Patient safety: a new basic science for professional education

“Patient safety is a core attitude and thus needs to be introduced early and then reinforced throughout postgraduate education and continuing professional development.” (Stefan Lindgren, President of the World Federation for Medical Education) Beginning in the 1990s, studies of hospital safety and quality from around the world have consistently found problems with patient safety and quality [1]. There has been a notable increase in awareness of the problem, with major efforts in the past two decades to improve the safety of medical care. A study conducted for the World Health Organization found that seven types of adverse events cause 43 million injuries a year, making preventable harm the world’s twentieth most common cause of overall morbidity andmortality [2]. Others have suggested that medical errors are even more common [3]. A chilling statistic fromWHO was that in high income countries, on average, one of every ten patients hospitalized suffers a serious, preventable adverse event [4]. Although patients continue to be harmed by health care, there has been some progress [5]. Since 2000, it has become widely understood and accepted that “it’s the system” – it is the health care system that creates hazards and harm, and that also creates patient safety, rather than individual providers [6]. However, there is a deeply seated, pernicious habit for people, the public and health care managers to blame specific medical errors exclusively on individual health professionals. On the other hand, it is certainly true that individuals are an integral and indispensable component of the health care system. Individuals also act as members of teams, and interact with other parts of the system [7]. Individual must feel they are accountable too. If the balance of accountability swings too far, and we rely entirely on searching for systems solutions, the important process of changing individual behaviors will be lost [8]. Regardless of whether you take an individual or system perspective on the causation of medical error, there is a need to educate clinicians on how to deliver safer care. We believe that patient safety should be a new basic science for professional education. To accomplish this, major reforms are needed in health professions education. However, we appreciate that there are challenges associated with incorporating patient safety into education and training. This special issue on patient safety in medical education in Germany represents an important step to increasing awareness of patient safety as an important element in the training of health professionals. The papers in this issue help to advance the field, in both education and in research on education.