Defining Patient Safety: a Student Perspective.

Abstract

Patient safety is recognised as an important aspect of the undergraduate medical curriculum. However, packed medical curricula have been slow to evolve despite repeated mandates and large-scale tragedies resulting from unlearnt lessons. The aim of this work was to explore students' perspectives on patient safety to inform curriculum re-design. Using a qualitative approach, medical students from year 2 and year 4 of the undergraduate course were invited to participate in focus groups to consider: their personal conceptualisation of patient safety, their perceptions of patient safety education in the existing curriculum and their collective preferences for future teaching in this area. Transcripts of the focus groups were subjected to thematic analysis. Six focus groups were convened with a total of 77 students. Thirteen major themes were identified which included conceptual ambiguity, healthcare culture, error theory, specific safety topics (such as infection prevention and control, medication safety, technical/procedural safety, communication and other non-technical skills), self-awareness, patient-centredness, low student morale and raising concerns. Students were more aware of technical than non-technical competence. They wanted learning aligned to the realities of practice, a clearer concept of patient safety and improved visibility of patient safety topics within an integrated curriculum. Students are keen to engage with safety topics but frequently feel disempowered as future change agents. Educators need to advocate a clear definition of patient safety and consider the implication of the theory-practice gap on students' evolving attitudes.