Abstract
BackgroundImplementing a patient safety curriculum for medical students requires to identify their needs and current awareness of the topic. Several tools have been developed to measure patient safety culture, but none of them have been developed in the French context.Our objective was to adapt and refine the psychometric properties of the MSSAPS, developed by Liao et al, to use it among general practice (GP) residents.Methods1-We conducted a translation and transcultural adaptation of the MSSAPS questionnaire (28 items, 5 dimensions: safety culture, teamwork culture, experiences with professionalism, error disclosure culture and comfort expressing professional concerns) in accordance with the international recommendations.2-We studied the new questionnaire’ psychometric properties on a sample of GP residency students in 2016. This validation comprised 2 steps: a confirmatory factor analysis (CFA) for each dimension of the MSAPPS to explore the adequacy of the structure of the questionnaire; an exploratory factor analysis to refine the instrument, using a principal component analysis and Cronbach’s α-coefficients calculation. A final CFA examined the structure validity of the refined questionnaire.3-We described the items and the safety cultural scores in our sample of residents.ResultsAmong 391 eligible students, 213 responded (54%).The initial structure was not confirmed by CFAs, showing a poor fit for 3 of the 5 dimensions: safety culture, teamwork culture and professionalism. Exploratory PCA led to 3 dimensions: Safety culture (PVE: 18.5% and 7 of 8 initial items), Experiences with professionalism (PVE: 17.8% and 5 of 7 initial items) and Error disclosure culture (PVE: 13.6% and 3 of 4 original items). Cronbach’s α-coefficients were 0.74, 0.78 and 0.76 respectively. The final CFA confirmed the existence of the 3 latent dimensions with a good fit to the and highly significant structural coefficients (P < 0.001). Mean scores were equal to 65.4 [63.6; 67.6] for the safety culture, 66.9 [63.8; 70.1] for the experience with professionalism, and 54.4 [51.6; 57.2] for the error disclosure culture.ConclusionThis study reports satisfactory psychometrics properties of the French version of the MSAPPS and provides evidence of important training needs for GP residents in the field of patient safety culture.
Highlights
Implementing a patient safety curriculum for medical students requires to identify their needs and current awareness of the topic
Patient safety culture has been defined by The European Society for Quality in Health Care as “an integrated pattern of individual and organizational behavior, based upon shared beliefs and values, that continuously seeks to minimize patient harm which may result from the processes of care delivery” [3]
This functional and open definition shows that patient safety culture does concern healthcare professionals and students, who play a key role in enhancing patient safety in hospitals
Summary
Implementing a patient safety curriculum for medical students requires to identify their needs and current awareness of the topic. Patient safety culture has been defined by The European Society for Quality in Health Care as “an integrated pattern of individual and organizational behavior, based upon shared beliefs and values, that continuously seeks to minimize patient harm which may result from the processes of care delivery” [3]. This functional and open definition shows that patient safety culture does concern healthcare professionals and students, who play a key role in enhancing patient safety in hospitals. Several aspects of its psychometric validation could be improved: some dimensions had unsatisfactory fit indices, one of them was saturated, and the fit of the overall model was not reported
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