Abstract
BackgroundDoctors and medical students have a professional responsibility to raise concerns. Failure to raise concerns may compromise patient safety. It is widely known that medical students frequently encounter unprofessional behaviours in the workplace, but little is known about the barriers to raising concerns amongst medical students. This paper explores these issues and discusses some innovations in the medical undergraduate curriculum, offering a good practice model for other medical and healthcare curricula.We set out to ascertain the attitudes and experiences of medical students in relation to raising concerns. This data was then used to innovate the raising concerns curriculum, and access to the raising concerns system, in order to fundamentally improve patient safety and experience, as well as the student experience.MethodsThe authors conducted a mixed methods quantitative and qualitative research study. Research was based at a UK medical school and involved data collection using an anonymous, voluntary survey emailed to all medical students (n = 363) as well as voluntary attendance focus groups (n = 24) recruited by email. Both tools investigated student attitudes towards raising concerns and explored student ideas for solutions to improving the process. The focus group data was thematically analysed by three researchers.ResultsThe authors identified five key themes which described medical student attitudes towards raising concerns. This article discusses these themes and the resulting work to enhance medical education within the medical school curriculum.ConclusionsMore research is needed to further address the barriers that medical students find in raising concerns. However, despite being a single study in one UK medical school, the authors propose some changes which they hope may inspire other educators to build upon their raising concerns curricula to foster more transparent undergraduate cultures and ultimately improve patient experience and safety.
Highlights
Doctors and medical students have a professional responsibility to raise concerns
Within the UK’s National Health Service (NHS), there have been reforms to protect those raising concerns or whistleblowing, following the Francis Report [2] and the Freedom to Speak Up Review [3]
Survey findings Of 1980 students emailed at University College London Medical School (UCLMS), 363 responded
Summary
Doctors and medical students have a professional responsibility to raise concerns. Failure to raise concerns may compromise patient safety. It is widely known that medical students frequently encounter unprofessional behaviours in the workplace, but little is known about the barriers to raising concerns amongst medical students. This paper explores these issues and discusses some innovations in the medical undergraduate curriculum, offering a good practice model for other medical and healthcare curricula. Students do not always feel able to address such situations [10, 12, 18, 20, 23] and may accept them as Johnson et al BMC Medical Education (2018) 18:171 part of the medical culture [15] These are problems studied across other healthcare professions including nurses, pharmacists, physiotherapists, and dentists [11]. Little research has been done on the raising concerns systems used by students
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