Just Culture for Medical Students: Understanding Response to Providers in Adverse Events

Brijen J. Shah, Bonnie Portnoy, Dennis Chang, Marc Napp

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Introduction: Individual and organizational response to an adverse event is a key part of the life cycle of a patient safety event. Just culture is a safety concept that emphasizes system drivers of human behavior. We developed a learning activity for medical students to teach and discuss just culture as part of a patient safety curriculum. Methods: This small-group, discussion-based learning activity was aimed at third-year medical students. Over 5 years, 628 students participated in it. The session had three components: a presession case-based survey, a didactic lecture, and a facilitated small-group discussion. Participants evaluated the session using our institution's standard learner assessment. They also took a postcourse test that contained multiple-choice questions relating to the session. Results: On a 5-point Likert scale (1 = poor, 3 = good, 5 = excellent), students rated the large-group lecture (3.2) and small-group discussion (3.2) moderately. Over 85% of students answered all knowledge items on a course posttest correctly. Discussion: This learning activity provides an easy-to-implement case-based discussion to introduce the concepts of just culture.

Original languageEnglish
Pages (from-to)11167
Number of pages1
JournalMedEdPORTAL : the journal of teaching and learning resources
StatePublished - 2021


  • Adverse Event
  • Case-Based Learning
  • Health Systems
  • Patient Safety
  • Quality Improvement/Patient Safety
  • Systems-Based Practice


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