Background: In 2016, ACGME’s first Clinical Learning Environment Review (CLER) report found that trainees had limited knowledge of Quality Improvement (QI) and patient safety (PS) concepts..

Purpose: We have designed a free, interactive, web-based game named SafetyQuest ( to teach QI and PS concepts. Objectives include:
1) Increasing knowledge regarding actions to promote safety such as event reporting and debriefing; 2) Using QI tools such as root cause analysis, PDCA, and A3 thinking; and 3) Introducing high level safety concepts such as reliability levels and human factors. Safetyquest consists of 20 cases across four levels. Each case contains a clinical scenario in which the learner must choose correct “safety actions” to prevent their patient from falling into harm’s way. This is followed by a set of multiple choice questions and a “QI mode,” where learner’s earn problem solving tools. Through game play, players receive immediate feedback and earn game points = “future lives saved”.

Description: We piloted SafetyQuest at Stanford in June 2016. We randomized medicine interns into two groups. The control group (n=19) played “Septris” a sepsis educational game while the intervention group (n=26) played “SafetyQuest.” In paired t-test analysis of pre and post-test data, we observed improvement in learner knowledge about PS concepts (p <0.0001) in the intervention group but not for those in the control group.

In June 2017, 45 medicine interns played SafetyQuest. In pre/post testing, we found statistically significant improvements in attitudes towards QI/PS and medical knowledge in key QI concepts (eg “what is a PDCA cycle”). In a follow up survey four months later, 90% of respondents said SafetyQuest was their top preferred independent learning method (compared to videos, articles and powerpoint).

Conclusions: This innovation is the first free, web-based game to teach QI and PS to physicians. Learners reported the game was preferable to other independent learning approaches.