Assessing Medical Students’ Perceptions of Patient Safety: The Medical Student Safety Attitudes and Professionalism Survey

• Published in: Academic medicine Vol. 89; no. 2; pp. 343 - 351
• Main Authors: Liao, Joshua M, Etchegaray, Jason M, Williams, S Tyler, Berger, David H, Bell, Sigall K, Thomas, Eric J
• Format: Journal Article
• Language: English
• Published: United States by the Association of American Medical Colleges 01-02-2014
• Subjects: Adult; Attitude of Health Personnel; Clinical Clerkship; Disclosure; Female; Hospitals, Teaching - standards; Humans; Male; Organizational Culture; Patient Safety; Professional Competence; Psychometrics - instrumentation; Reproducibility of Results; Students, Medical - psychology; Surveys and Questionnaires
• ISSN: 1040-2446; 1938-808X
• DOI: 10.1097/ACM.0000000000000124

PURPOSETo develop and test the psychometric properties of a survey to measure students’ perceptions about patient safety as observed on clinical rotations.
METHODIn 2012, the authors surveyed 367 graduating fourth-year medical students at three U.S. MD-granting medical schools. They assessed the survey’s reliability and construct and concurrent validity. They examined correlations between students’ perceptions of organizational cultural factors, organizational patient safety measures, and students’ intended safety behaviors. They also calculated percent positive scores for cultural factors.
RESULTSTwo hundred twenty-eight students (62%) responded. Analyses identified five cultural factors (teamwork culture, safety culture, error disclosure culture, experiences with professionalism, and comfort expressing professional concerns) that had construct validity, concurrent validity, and good reliability (Cronbach alphas > 0.70). Across schools, percent positive scores for safety culture ranged from 28% (95% confidence interval [CI], 13%–43%) to 64% (30%–98%), while those for teamwork culture ranged from 47% (32%–62%) to 74% (66%–81%). They were low for error disclosure culture (range10% [0%–20%] to 27% [20%–35%]), experiences with professionalism (range7% [0%–15%] to 23% [16%–30%]), and comfort expressing professional concerns (range17% [5%–29%] to 38% [8%–69%]). Each cultural factor correlated positively with perceptions of overall patient safety as observed in clinical rotations (r = 0.37–0.69, P < .05) and at least one safety behavioral intent item.
CONCLUSIONSThis study provided initial evidence for the survey’s reliability and validity and illustrated its applicability for determining whether students’ clinical experiences exemplify positive patient safety environments.