Patient Safety Knowledge and Its Determinants in Medical Trainees
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Patient safety is a core educational topic for medical trainees.
To determine the current level and determinants of patient safety knowledge in medical trainees.
Multi-institutional cross-sectional assessment of patient safety knowledge.
Residents and medical students from seven Harvard-affiliated residencies and two Harvard Medical School courses.
Participants were administered a 14-item validated test instrument developed based on the patient safety curriculum of the Risk Management Foundation (Cambridge, MA). The primary outcome measure was the amount of patient safety knowledge demonstrated by trainees on the validated test instrument. The secondary outcome measure was their subjective perceptions as to their baseline knowledge level in this domain.
Ninety-two percent (640/693) of residents and medical students completed the patient safety test. Participants correctly answered a mean 58.4% of test items (SD 15.5%). Univariate analyses show that patient safety knowledge levels varied significantly by year of training (p = 0.001), degree program (p < 0.001), specialty (p < 0.001), country of medical school (p = 0.006), age (p < 0.001), and gender (p = 0.050); all but the latter two determinants remained statistically significant in multivariate models. In addition, trainees were unable to assess their own knowledge deficiencies in this domain.
Patient safety knowledge is limited among medical trainees across a broad range of training levels, degrees, and specialties. Effective educational interventions that target deficiencies in patient safety knowledge are greatly needed.
KEY WORDSsafety medical errors medical education
We thank the RMF (Cambridge, MA) for use of their web-based educational materials; Robert B. Hanscom and Elizabeth G. Armstrong for their support of the program; Lucean L. Leape and Saul N. Weingart for editing and content validation of the patient safety test items; Ronald A. Arky, Stanley W. Ashley, Christopher C. Baker, Eugene Beresin, Lori R. Berkowitz, Charlie M. Fergusen, Joel T. Katz, Hope A. Riccotti, William Taylor, and Carrie D. Tibbles for including their programs/courses in the web-based program; Daniel D. Federman for support in the conception of the program and assistance in its financial administration; and Susan Herlihy, Jessica E. Hyde, and Colleen E. Graham for administrative support. The views expressed in this article are those of the authors and do not necessarily reflect the position and policy of the United States Federal Government or the Department of Veterans Affairs. No official endorsement should be inferred. This study was supported by a grant from the RMF, Cambridge, MA. Additional support was obtained from the Research Career Development Award Program and research grants TEL-02-100 and IIR-04-045 from the Veterans Affairs Health Services Research & Development Service, the American Urological Association Foundation (Linthicum, MD), Astellas Pharma U.S., the National Institutes of Health (K24 DK63214 and R01 HL77234), and the Academy at Harvard Medical School. The study protocol was reviewed and approved by the institutional review board at Harvard Medical School.
Conflict of interest
Dr. Kerfoot had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Conception and design: Kerfoot, Conlin, Travison, and McMahon. Acquisition of data: Kerfoot and McMahon. Analysis and interpretation of data: Kerfoot, Conlin, Travison, and McMahon. Drafting of the manuscript: Kerfoot and Travison. Critical revision of the manuscript for important intellectual content: Conlin and McMahon. Statistical analysis: Kerfoot and Travison. Obtaining funding: Kerfoot and Conlin. Administrative, technical, or material support: Conlin, Travison, and McMahon. Supervision: Conlin and McMahon
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