Attitudes Toward Patient Safety Among Final-Year Medical Students and Interns at a Teaching Hospital in Kerala: A Cross-Sectional Study.

BACKGROUND

With the advancements in medicine, medical technologies, and diagnostics, patient safety is expected to be one of the priorities of modern medicine. However, in India, several medical error-related deaths have been recorded. Medical students today are the future healthcare providers, and hence, understanding their attitudes toward patient safety is crucial. The objective of this study was to determine the attitudes of medical students and interns toward patient safety and the factors associated with it at a teaching hospital in Ernakulam, Kerala.

METHODS

A cross-sectional study was undertaken among the final-year medical students and interns at a tertiary care teaching hospital in Kerala. Their attitude was assessed using the Attitude to Patient Safety Questionnaire III (APSQ III). The nine domains of the APSQ III were "patient safety training received, error reporting confidence, working hours as the cause of errors, error inevitability, professional incompetence as the cause of errors, disclosure responsibility, team functioning, patient involvement in reducing errors, and the importance of patient safety in the curriculum." Convenience (non-probability) sampling was done, and all final-year medical students and interns were invited to participate in the study. Data were collected via Google Forms and were analyzed using IBM SPSS Statistics for Windows, Version 21.0 (Released 2012; IBM Corp., Armonk, NY). All scores have been reported as mean with SD, and univariate analysis was done using an independent samples t-test. The independent variables were the age of the participants, gender, and year level. The Institutional Ethics Committee provided ethical clearance for the study.

RESULTS

A total of 144 students responded, of which 87 were female students (60.4%) and 82 (56.9%) were final-year Bachelor of Medicine and Bachelor of Surgery students. The overall score for the APSQ III was 5.31 ± 0.51, indicating an overall positive attitude. Six of the nine domains of the APSQ III reflected a positive attitude. The "working hours as the cause of errors" domain attained the highest mean score of 6.2, with a statistically significant difference between different age groups (p = 0.02). The domain "disclosure responsibility" showed a significant difference between genders (p = 0.02). The majority of the interns proposed an increased number of working hours to be the cause of medical errors (p = 0.001).  Conclusion: Though all students had an overall positive attitude toward patient safety, the domains "patient safety training received," "professional incompetence as the cause of errors," and "disclosure responsibility" were perceived with a negative attitude. Hence, a structured education program with assessments on patient safety training should be included in the medical curriculum to ensure that errors are minimized.