1.

Define and understand basic patient safety terms such as adverse event, near miss, and root cause analysis.

2.

Identify the potential for error within the system and the importance of learning how to effectively engage the system at multiple levels.

3.

Recognize and define key types of medical errors.

4.

Understand the different types of cognitive errors.

5.

Demonstrate effective teamwork skills involved in error analysis and root cause analysis.

6.

Draw and illustrate a written diagram of an Ichikawa fishbone root cause analysis to identify the root causes of the medication error.

7.

Investigate the types of medical error present and develop an action plan for the prevention of error in the future based on the root cause analysis.

8.

Apply the types of medical error to the morbidity or mortality case.

9.

Recognize the potential for error within the health care system.

10.

Identify areas in their own practice and local system that can be changed to improve the processes and outcomes of care.

11.

Develop collaborative teamwork skills using a shared learning model with peers.