BMJ Qual Saf. 2013 Aug;22(8):609-12. doi: 10.1136/bmjqs-2012-001637. Epub 2013 May 25.
The evidence shows that notwithstanding efforts by health professionals and hospital managers to improve the quality and safety of healthcare, adverse events remain prevalent. Clinical supervision is understandably dominated by transferring discipline knowledge and skills but the environment today requires equal attention to integrating patient safety concepts and principles into clinical supervision. Trainees learn from supervisors who themselves often have inadequate patient safety knowledge and skills. This conundrum may partly explain why there has been no visible reduction in adverse events. Patient safety literature has emphasised that clinical errors are rarely linked with incompetent doctors or trainees with inadequate knowledge but rather to failures in appreciating the context, complexity and uncertainty of clinical decisions made under the pressure of time. It is time to consider whether clinical supervisors themselves first need to demonstrate patient safety competencies before being responsible for supervising trainees.
证据表明，尽管卫生专业人员和医院管理人员努力提高医疗保健的质量和安全性，但不良事件仍然普遍存在。临床监督理所当然地以传授学科知识和技能为主导，但如今的环境要求同等重视将患者安全理念和原则融入临床监督中。受训者向监督者学习，而监督者本身往往缺乏患者安全知识和技能。这种困境或许部分解释了为什么不良事件没有明显减少。患者安全文献强调，临床错误很少与能力不足的医生或知识不足的受训者有关，而更多的是与未能理解临床决策的背景、复杂性和不确定性有关，这些决策是在时间紧迫的压力下做出的。现在是时候考虑一下，在负责监督受训者之前，临床监督者自己是否首先需要展示患者安全能力。
