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Patient safety: time for a transformational change in medical education

William B Runciman
Med J Aust 2010; 193 (1): . || doi: 10.5694/j.1326-5377.2010.tb03728.x
Published online: 5 July 2010

A major change in medical teaching practices is needed to improve patient safety

The Lucien Leape Institute, in Boston, USA, was formed in 2007 to provide a strategic vision for improving patient safety, and is composed of national “thought leaders” (http://www.npsf.org/lli/). The Institute has produced a report on the urgent need to reform medical education,1 and states that many believe we are at a transformational moment similar to that which led to the profound changes in medical education following the release of the Flexner report in the United States 100 years ago.2


  • School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, SA.



Acknowledgements: 

NHMRC New Program Grant 568612.

Competing interests:

I provide general advice on patient safety to the iSOFT Group.

  • 1. Lucian Leape Institute Roundtable on Reforming Medical Education. Unmet needs: teaching physicians to provide safe patient care. Boston: National Patient Safety Foundation, 2010. http://www.npsf.org/download/LLI-Unmet-Needs-Report.pdf (accessed Apr 2010).
  • 2. Flexner A. Medical education in the United States and Canada. New York: Carnegie Foundation for the Advancement of Teaching, 1910. http://www.carnegiefoundation.org/sites/default/files/elibrary/Carnegie_Flexner_Report.pdf (accessed May 2010).
  • 3. Kohn LT, Corrigan JM, Donaldson MS, editors. To err is human: building a safer health system. Washington DC: The National Academies Press, 2000.
  • 4. UK Department of Health. An organisation with a memory: report of an expert group on learning from adverse events in the National Health Service, chaired by the Chief Medical Officer. London: The Stationery Office, 2000. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4065086.pdf (accessed May 2010).
  • 5. Runciman WB, Moller J. Iatrogenic injury in Australia. Adelaide: Australian Patient Safety Foundation, 2001. http://www.apsf.net.au/dbfiles/Iatrogenic_Injury.pdf (accessed May 2010).
  • 6. Wilson RM, Runciman WB, Gibberd RW, et al. The quality in Australian health care study. Med J Aust 1995; 163: 458-471. <MJA full text>
  • 7. Wilson RM, Van der Weyden MB. The safety of Australian healthcare: 10 years after QAHCS. Med J Aust 2005; 182: 260-261. <MJA full text>
  • 8. Braithwaite J, Runciman WB, Merry AF. Towards safer, better healthcare: harnessing the natural properties of complex sociotechnical systems. Qual Saf Health Care 2009; 18: 37-41.
  • 9. Runciman B, Merry A, Walton M. Safety and ethics in healthcare: a guide to getting it right. Farnham: Ashgate Publishing, 2007: 9.
  • 10. Reason J. The human contribution: unsafe acts, accidents and heroic recoveries. Farnham: Ashgate Publishing, 2008.

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