Why is patient safety a challenge? Insights from the Professionalism Opinions of Medical Students’ (PoMS) Research

Abstract

Introduction Despite increased emphasis on education and training for patient safety in medical schools, there is little known about factors influencing decision making regarding patient safety behaviours. This study examined the nature and magnitude of factors which may influence opinions around patient safety related behaviours as a means of providing insights into how Australian doctors and medical students view these issues relative to members of the public. Methods A national, multicentre, prospective, online cross sectional survey was conducted using responses to hypothetical clinical scenarios. Three cohorts were surveyed Australian enrolled medical students, medical doctors and members of the public. Participant responses were compared for the different contextual variables within the scenarios and the participants demographic characteristics student, doctor, member of the public, gender and age (if public or doctors)/ seniority in the course (if a medical student). Results In total there were 2602 medical student participants, 809 doctors and 503 members of the Australian public. Medical doctors were more likely than other cohorts to have statistically significant differences in how they viewed the acceptability of patient safety related behaviours; doctors were more tolerant of medical students not reporting concerning behaviours. Medical students opinions frequently demonstrated a transition effect, bridging between the doctors and publics attitudes, consistent with professional identity formation. Conclusions Opinions on the acceptability of medical students patient safety related behaviours were influenced by the demographics of the cohort and the contextual complexity of the scenario. Although the survey used hypothetical scenarios, doctors and medical students opinions appear to be influenced by cognitive dissonances, biases and heuristics which may negatively affect patient safety.