Housestaff and medical student attitudes toward medical errors and adverse events

Abstract

Background: A lack of formal patient safety curricula has contributed to the suboptimal training of medical students and housestaff. Attitudes of physician trainees regarding medical errors and adverse events were surveyed in a pilot study.

Methods: Five hundred sixty-three physician trainees were surveyed at an urban teaching hospital. Five domains were evaluated using a factor analysis as they relate to patient safety: knowledge, self-efficacy, awareness of safety culture, barriers/facilitators, and awareness of human factors.

Results: One hundred fifty-eight (28%) trainees completed the survey, with 22% (n = 35) describing exposure to at least one adverse medical event. The survey showed good internal validity and reliability. Respondents who reported exposure to adverse events demonstrated a lower awareness of human factor errors (p = .0017) and lower awareness of the hospital's approach to safety (p = .033). Older respondents scored higher on measures of self-efficacy than younger trainees (p = .042).

Discussion: The exposure of physician trainees to errors and adverse events can have a negative effect on their attitudes and competencies. Exposure to adverse events and the institution's response may decrease both error reporting and the willingness to adopt safety practices. The results support the need for implementing a sustained patient safety curriculum that promotes learning regarding adverse events.