Residents, fellows, and faculty members are essential members of the health care team and, as such, their participation is important to achieving the CLE's goals for patient safety. Critical to resident, fellow, and faculty physician participation is their ability to clearly understand and recognize what defines a patient safety event, near miss/close call, or unsafe condition and their responsibility to report such occurrences.

Didactic approaches such as presentations during resident orientation and web-based modules on patient safety may be helpful but are insufficient. Experiential learning, through participation in activities such as interprofessional, interdisciplinary reviews of patient safety events, enables residents, fellows, and faculty members to apply a systems approach to identify and address potential causes of harm. In addition, the experience of receiving feedback encourages reporting and helps residents, fellows, and faculty members understand how patient safety can be improved in individual departments and across the organization. When a resident, fellow, or faculty member receives no response to his/her report, it deters future reporting. Each report is a potential learning experience as well as an opportunity to improve patient care.

Broadly communicating the key learnings and improvement plans from patient safety event reviews to residents, fellows, faculty members, and other staff will help promote the value of CLE efforts to improve patient safety. Through this, CLEs and GME can join together to create a culture of safety and teach residents and fellows about the role of systems thinking in forging sustainable improvements in health care.

Leaders in the CLEs and the GME community must also ensure that faculty members have the skills to educate and train residents and fellows to become competent in risk identification, harm reduction, and creating a culture of safety. Without good role models, residents and fellows may receive messages from the faculty members (either implicit or explicit) that contradict the CLE's efforts to create a culture of quality and safety. That could leave the next generation of physicians ill prepared to advance the teaching and practice of safe care.

CLER National Report of Findings - 2016