A 2012 survey-based study of 142 dermatology residents from 44 US and Canadian residency programs was conducted to identify the source of clinical practices among dermatology residents that affect patient safety and determine the best approach for overcoming gaps in knowledge and practice patterns that contribute to these practices. The survey was conducted at a national medical dermatology meeting in Itasca, IL. The results were published in JAMA Dermatology online on April 09, 2014

Of the dermatology residents surveyed:

o   45.2 percent have failed to report needle-stick injuries incurred during procedures

o   82.8 percent reported cutting and pasting a previous author's patient history information into a medical record without confirming its validity

o   96.7 percent reported right-left body part mislabeling during examination or biopsy

o   29.4 percent reported not incorporating clinical photographs of lesions sampled for biopsy in the medical record at their institution

o   20.0 percent always perform a purposeful “time-out” when indicated to confirm patient, procedure, and site before biopsy, with most only doing it variably.

o   59.7 percent work with at least one attending physician who intimidates the residents, reducing the likelihood of reporting safety issues they witness

o   78.3 percent have witnessed attending physicians purposefully disregarding required safety steps.

The authors concluded, “Our data reinforce the need for modified curricula, systems, and teacher development to reduce injuries, improve communication with patients and between physicians, residents, and other members of the health care team, and create an environment free of intimidation.”