Chaneliere M, Jacquet F, Occelli P, Touzet S, Siranyan V, Colin C
Health Services and Performance Research (HESPER), 162 Avenue Lacassagne Bât A-F69424, Lyon, cedex 03, France.
Claude Bernard University Lyon 1 (UCBL), 8 avenue Rockefeller, F 69373, Lyon, Cedex 08, France.
BMC Med Educ. 2016 Sep 29;16(1):255. doi: 10.1186/s12909-016-0778-y.
The assessment of patient safety culture refers mainly to surveys exploring the perceptions of health professionals in hospitals. These surveys have less relevance when considering the assessment of the patient safety culture of medical students, especially at university or medical school. They are indeed not fully integrated in care units and constitute a heterogeneous population. This work aimed to find appropriate assessment tools of the patient safety culture of medical students.
Systematic review of the literature. Surveys related to a care unit were excluded. A typology of the patient safety culture of medical students was built from the included surveys.
Eighteen surveys were included. In our typology of patient safety culture of medical students (15 dimensions), the number of dimensions explored by survey (n) ranged from 1 to 12, with 6 "specialized" tools (n ≤ 4) and 12 "global" tools (N ≥ 5). These surveys have explored: knowledge about patient safety, acknowledgment of the inevitability of human error, the lack of skills as the main source of errors, the errors reporting systems, disclosure of medical errors to others health professionals or patients, teamwork and patient involvement to improve safety in care.
We recommend using Wetzel's survey for making an overall assessment of the patient safety culture of medical students at university. In a specific purpose-e.g. to assess an educational program on medical error disclosure-the authors recommend to determine which dimensions of patient safety will be taught, to select the best assessment tool. Learning on patient safety should however be considered beyond the university. International translations of tools are required to create databases allowing comparative studies.
患者安全文化评估主要指通过调查来探究医院医护人员的看法。在考虑医学生的患者安全文化评估时，尤其是在大学或医学院，这些调查的相关性较低。医学生实际上并未完全融入护理单元，且构成一个异质性群体。这项工作旨在找到适用于医学生患者安全文化的评估工具。
对文献进行系统综述。排除与护理单元相关的调查。根据纳入的调查建立医学生患者安全文化的类型学。
纳入了18项调查。在我们构建的医学生患者安全文化类型学（15个维度）中，各调查所探究的维度数量（n）从1到12不等，其中有6种“专门”工具（n≤4）和12种“综合”工具（n≥5）。这些调查探究了：患者安全知识、对人为错误不可避免性的认知、缺乏技能作为错误的主要来源、错误报告系统、向其他医护人员或患者披露医疗错误、团队合作以及患者参与以提高护理安全。
我们建议使用韦策尔的调查来全面评估大学医学生的患者安全文化。在特定目的下，例如评估关于医疗错误披露的教育项目，作者建议确定要教授患者安全的哪些维度，以选择最佳评估工具。然而，对患者安全的学习应超越大学范畴。需要对工具进行国际翻译以创建数据库，从而开展比较研究。
