Patient safety and the second victim phenomenon in nursing and medical curricula : a qualitative study

Abstract

Background: The second victim phenomenon—emotional and psychological distress experienced by healthcare professionals following adverse events—is increasingly recognized. However, its integration into formal nursing and medical curricula remains limited across Europe, despite its relevance to patient safety, as well as student and clinician well-being. Objectives: To explore how patient safety and second victim content are incorporated into undergraduate and postgraduate nursing and medical curricula and to identify the barriers and facilitators influencing such integration across Europe. Design: A qualitative cross-national interview study. Settings: Medical and nursing education institutions in 10 European countries representing northern, southern, central, and eastern regions. Participants: Nineteen healthcare education leaders (department heads or senior faculty) from nursing and medical programs were selected purposefully based on their leadership roles and curricular oversight responsibilities. Inclusion criteria required at least 5 years of experience in curriculum development at both undergraduate and postgraduate levels; there were no dropouts. Methods: Semi-structured interviews were conducted in participants’ native languages, translated to English, and analyzed using thematic analysis. Themes were developed inductively by a multidisciplinary research team across countries. Results: Five major themes were identified: (1) Recognition of patient safety and the second victim phenomenon; (2) Curriculum development and implementation; (3) Training content and delivery; (4) Student and educator engagement; and (5) Continuous professional development. Although awareness of the second victim concept was high, formal curricular integration was rare. Barriers included curriculum overload, regulatory rigidity, and limited faculty preparedness. Facilitators included interdisciplinary collaboration, student advocacy, and openness to innovative pedagogies. Conclusions: Despite broad recognition of the second victim phenomenon, its integration into European healthcare curricula remains minimal. Strategic curriculum reforms supported by interdisciplinary collaboration, institutional leadership, and student engagement may be essential to bridge the gap between awareness and educational practice. We have offered actionable guidance for advancing patient safety and clinician resilience through formal education.