From Error to Insight: A Curriculum Tool for Resident Education in Patient Safety, Quality Improvement, and Adverse...

To evaluate whether a 3-part dermatology-specific curriculum improves resident competency in process mapping, root cause analysis, and adverse event disclosure.

A pre-post educational intervention study was conducted in 2025 across 3 ACGME-accredited dermatology residency programs affiliated with a Texas-based academic medical center. The curriculum consisted of 3 sequential 1-hour sessions covering patient safety fundamentals, quality improvement tool application via flipped classroom, and peer-led adverse event disclosure simulation. Primary outcomes measured self-reported confidence in systems analysis, root cause analysis, and disclosure communication using 5-point Likert scales. Secondary outcomes assessed the knowledge of dermatology-specific error types and disclosure components. Twenty-seven residents completed pre-intervention surveys and 20 completed post-intervention surveys. Data were analyzed using Mann-Whitney U test and Fisher exact test.

Residents demonstrated significant improvements across all primary competencies. Median confidence in process mapping increased from 1 to 4 (P<0.001), fishbone diagramming from 2 to 4 (P<0.001), and adverse event disclosure from 3 to 4 (P=0.001). Knowledge of common outpatient dermatology error types improved from 7.4% to 60% correct responses (P=0.00019). No significant differences were observed by postgraduate year level. Postcourse evaluations showed 95% rated duration as appropriate and 100% reported improved knowledge.

Study limitations include reliance on self-reported measures, anonymous survey design precluding paired analysis, modest sample size, lower postintervention response rates with potential volunteer and nonresponse bias due to voluntary participation, and single-institution implementation without long-term follow-up assessment; the curriculum was locally developed without external funding or institutional support that influenced its design or implementation.

This dermatology-specific curriculum significantly improved resident competencies in systems analysis, root cause analysis, and adverse event disclosure. The specialty-focused design and scalable peer-led simulation model offer a practical approach for adoption across dermatology residency programs.