Abstract
BackgroundIn undergraduate medical education, patient safety concepts and understanding of medical errors are under-represented. This problem is more evident in low-income settings. The aim of this study was to explore undergraduate medical students’ attitudes towards patient safety in the low-income setting of the Gaza Strip.MethodsA cross-sectional, descriptive study included medical students of the two medical schools in the Gaza Strip with 338 medical students completing the Attitudes to Patient Safety Questionnaire-IV (APSQ-IV), which examines patient attitudes in 29 items over 10 domains. Results are represented as means ± standard deviations for each item and domain as well as percentage of positive responses to specific items.ResultsMedical students reported slightly positive patient safety attitudes (4.7 ± 0.5 of 7) with the most positive attitudes in the domains of situational awareness, importance of patient safety in the curriculum, error inevitability and team functioning. While no negative attitudes were reported, neutral attitudes were found in the domains of professional incompetence as a cause of error and error reporting confidence. Study year and gender had no significant association with patient safety attitudes, except for disclosure responsibility, where male students displayed significantly more positive attitudes. The study university was significantly associated with three of the 10 examined domains, all of which involved understanding of medical errors, for which students of University 2 (who had undergone limited patient safety training) held significantly more positive attitudes, compared with students of University 1 (who did not have structured patient safety training).ConclusionMedical students’ patient safety attitudes were very similar among students from both universities, except for understanding of medical error, for which students, who had received structured training in this topic, displayed significantly more positive attitudes. This underlines the power of the ‘hidden curriculum’, where students adjust to prevalent cultures in local hospitals, while they do their clinical training. Furthermore, it highlights the need for a systematic inclusion of patient safety content in local undergraduate curricula.
Highlights
IntroductionPatient safety concepts and understanding of medical errors are under-represented
In undergraduate medical education, patient safety concepts and understanding of medical errors are under-represented
Medical students participating in this study demonstrated slightly positive attitudes toward patient safety
Summary
Patient safety concepts and understanding of medical errors are under-represented. Different studies showed conflicting results in the impact of study year on patient safety attitudes, where some found students in earlier years demonstrating more positive patient safety attitudes and others, mainly US and UK based studies, found final year students with more positive attitudes [13, 17,18,19,20] This difference could be driven either by more positive patient safety attitudes prevalent in the health systems of high-income countries, by more systematic integration of patient safety content in undergraduate curricula than currently is the case in low- and middleincome countries or by a combination of both these factors [21,22,23,24]. Undergraduate patient safety interventions have been effective in producing improvement in patient safety attitudes, as well as selfreported behaviours, but better patient outcomes as a result of patient safety interventions at an undergraduate level still have to be proven [21,22,23,24]
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