Blasiak Rachel C, Stokes Claire L, Meyerhoff Karen L, Hines Rachel E, Wilson Lindsay A, Viera Anthony J
Corresponding author: Public Health Leadership Program, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Public Health Leadership Program, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
N C Med J. 2014 Jan-Feb;75(1):15-20. doi: 10.18043/ncm.75.1.15.
The Association of American Medical Colleges and the World Health Organization have endorsed formal patient safety and quality improvement (QI) education for medical students. We surveyed medical students to assess their current level of patient safety and QI knowledge and to identify factors associated with increased knowledge.
A literature review, focus groups with medical students, and local expert interviews were used to develop an electronic survey, which was distributed to all medical students at a single medical school in the spring of 2012.
Fifty-seven percent of the medical school student body (N = 790) participated in the survey. A greater proportion of students reported previous exposure to patient safety education than to QI education (79% vs 47%). Students scored an average of 56% and 58% on the patient safety and QI knowledge tests, respectively. Having or pursuing an advanced degree (P = .02) and previous exposure to patient safety education (P = .02) were associated with higher knowledge scores. After adjusting for confounding variables, only previous exposure to QI education (P = .02) was associated with higher QI knowledge scores.
There is a risk of measurement bias due to the use of an unvalidated instrument. Students who have greater knowledge of patient safety or QI might recall exposure at a greater frequency, inflating the association between exposure and knowledge. Also, this is a cross-sectional study, so we cannot draw conclusions about causality.
Medical students' knowledge of patient safety and QI is low. Previous formal or informal education about these topics is associated with increased knowledge.
美国医学院协会和世界卫生组织已认可对医学生进行正式的患者安全与质量改进（QI）教育。我们对医学生进行了调查，以评估他们目前的患者安全和QI知识水平，并确定与知识增加相关的因素。
通过文献综述、与医学生进行焦点小组讨论以及与当地专家访谈，开发了一项电子调查问卷，并于2012年春季分发给一所医学院的所有医学生。
该医学院学生群体的57%（N = 790）参与了调查。报告曾接受过患者安全教育的学生比例高于接受过QI教育的学生比例（79%对47%）。学生在患者安全和QI知识测试中的平均得分分别为56%和58%。拥有或正在攻读高级学位（P = .02）以及曾接受过患者安全教育（P = .02）与更高的知识得分相关。在对混杂变量进行调整后，只有曾接受过QI教育（P = .02）与更高的QI知识得分相关。
由于使用了未经验证的工具，存在测量偏倚的风险。对患者安全或QI有更多了解的学生可能会更频繁地回忆起相关接触经历，从而夸大接触与知识之间的关联。此外，这是一项横断面研究，因此我们无法得出因果关系的结论。
医学生对患者安全和QI的知识水平较低。此前关于这些主题的正式或非正式教育与知识增加相关。
