Undergraduate medical students' behavioural intentions towards medical errors and how to handle them: A qualitative vignette study

Objectives In undergraduate medical education, the topics of errors in medicine and patient safety are under-represented. The aim of this study was to explore undergraduate medical students' behavioural intentions when confronted with an error. Design A qualitative case vignette survey was conducted including one of six randomly distributed case scenarios in which a hypothetical but realistic medical error occurred. The six scenarios differed regarding (1) who caused the error, (2) the presence of witnesses and (3) the consequences of the error for the patient. Participants were asked: â € What would you do?". Answers were collected as written free texts and analysed according to qualitative content analysis. Setting Students from German medical schools participated anonymously through an online questionnaire tool. Participants Altogether, n=159 students answered a case scenario. Participants were on average 24.6 years old (SD=7.9) and 69% were female. They were undergraduate medical students in their first or second year (n=27), third, fourth or fifth year (n=107) or final year (n=21). Results During the inductive coding process, 19 categories emerged from the original data and were clustered into four themes: (1) considering communication; (2) considering reporting; (3) considering consequences; and (4) emotional responsiveness. When the student him/herself caused the error in the scenario, participants did mention communication with colleagues and taking preventive action less frequently than if someone else had caused the error. When a witness was present, participants more frequently mentioned disclosure of the error and taking actions than in the absence of a witness. When the outcome was significant to the patient, participants more often showed an emotional response than if there were no consequences. Conclusions The study highlights the importance of coping strategies for healthcare professionals to adequately deal with errors. Educators need to introduce knowledge and skills on how to deal with errors and emotional preparedness for errors into undergraduate medical education

Validation of a German short version of the Attitudes towards Patient Safety Questionnaire (G-APSQshort) for the measurement of undergraduate medical students' attitudes to and needs for patient safety

Introduction: Topics of patient safety are being taught increasingly within medical eudcation. To date, however, there is no suitable means of measuring the status quo of medical students’ attitudes towards patient safety in German-speaking Europe. The German validation of a short version of the Attitude towards Patient Safety Questionnaire (G-APSQ) is meant to fill this gap with the aid of two validation studies. Methods: In Study 1, item and reliability analyses were used to examine internal consistency as well as factorial structure. In Study 2, the measurement sensitivity of the G-APSQ in detecting changes in attitudes was assessed. Results: Study 1 comprised N=83 participants (M=23.16 years; 21 female). Adequate internal consistency (Cronbach’s α=.722-.903) was reached in 6 of the seven subscales. The factor analysis showed that the six extracted factors matched the theoretically conceived subscales.Study 2 comprised N=21 participants (M=26 years; 11 female). A multivariate analysis of variance showed that the differences before and after a short-term intervention were significant with medium effect size (F(1;16)=6.675; p<.05; η=.29).Discussion: In six subscales, the G-APSQ can be considered valid in respect to measuring point and change. It is hoped that regular and concerted implementation of measuring instruments such as the G-APSQ will help to develop a common ground for data comparison among many different German-speaking medical faculties