Why It Matters
Why should a medical school offer a dedicated course on patient safety? When Frank Filipetto, DO, was asked this question, he responded, “No one asks me why I teach about cardiovascular disease or cancer.” Filipetto added, “It’s plain and simple. Preventable deaths from medical harm are among the top causes of death. We can teach how to avoid preventable harm.”
In 2019, Filipetto became dean of the Texas College of Osteopathic Medicine (TCOM) at the University of North Texas Health Science Center (HSC). TCOM is the first, and so far only, medical school in the country to offer a course specifically designed to prepare students for the Certified Professional in Patient SafetyTM (CPPS) credential. This credential is awarded to those who pass a board certification examination covering five patient safety domains: culture; leadership; patient safety risks and solutions; measuring and improving performance; systems thinking and design; and human factors.
The innovative curriculum was developed as part of a longitudinal Professional Identity and Health Systems Practice Course with Janet Lieto, DO, FACOFP, CMD, CPPS, who is the Course Director. Patient Safety is part of Health Systems Sciences and enables students to see themselves as part of the health care system. Dr. Lieto, in collaboration with Dr. Lillee Gelinas, DNP, RN, CPPS, FAAN, who is Patient Safety Section Director at TCOM, developed content and a positive educational instructional design that fit students’ needs. In addition, TCOM leadership embraced the curriculum: “Everyone was aligned with that mission of patient safety — the provost, the president,” said Lieto. “Everyone’s support was there. They were passionate about it, and they valued it.”
The main motive behind the course was to fill a serious gap in standard medical education. While the Institute for Healthcare Improvement (IHI) offers a CPPS review course for professionals, this curriculum broke new ground in preparing medical students to earn the credential. Designing the TCOM course “gave us the opportunity to think a little more upstream,” said Filipetto. The standard medical school curriculum, he argued, has been failing patients. “TCOM is not interested in graduating medical students who continue to practice medicine the same way we have the last 100 years,” he said. When medical education stays focused on just the basic and clinical sciences, “we wonder why our health care system isn’t changing. I’m not interested in having the US rank dead last compared to other countries similar to us in outcomes. It’s a crisis, it’s a shame.”
Filipetto also perceived that the CPPS credential would give his students an advantage in the job market. “They all leave here with this competency,” he said. “You have some schools that may teach patient safety, but we require students to get certification. That raises it to the next level of accountability.”
Though the CPPS requirement initially faced some skepticism from students, they now appreciate its value. “Students better understand the importance of Health Systems Sciences taught in Patient Safety and how it effects their growth as future physicians,” said Lieto. “They begin to realize that while patient-physician relationships are important, the health care system will also influence how they provide safe and quality care.”
TCOM graduates have already seen benefits. One graduate, during orientation for his residency, was wearing a white coat that displayed his credentials: DO, CPPS. An attending physician who was a patient safety committee member recognized the certification initials and said, “Oh, you’re certified? We need you on the patient safety committee at this hospital.”
The course’s success is evident in the students’ performance on the CPPS Certification exam. In the first year it was offered, fourth-year students who participated in the curriculum had a 100 percent first-time pass rate. For third-year students, the first-time pass rate since the course’s launch is 93 percent. Including students who failed the exam the first time and retook it, the overall pass rate for 2020-2021 academic year students was 98 percent.
Students are not the only ones getting certified. In less than 18 months, 24 TCOM faculty members have become CPPS certified, including Filipetto. “In addition to physicians, our ethicist, psychologists and nurse practitioners are CPPS-certified,” said Lieto. “The students have these initials after their names and we needed to make sure our faculty understood what the certification means and how they can help our students grow.”
Filipetto relishes the fact that his students have a competitive edge in the market, and he hopes his school can continue this distinction. However, he says, “There’s a method behind what we do that could be implemented into most medical schools.” Both Filipetto and Lieto emphasize the importance of passionate champions and leadership buy-in, for example. If becoming CPPS certified were incorporated into “every med school in the country—now you’ve got something transformational,” said Filipetto.
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