A cross-sectional study of medical students' knowledge of patient safety and quality improvement.
BACKGROUND
The Association of American Medical Colleges and the World Health Organization have endorsed formal patient safety and quality improvement (QI) education for medical students. We surveyed medical students to assess their current level of patient safety and QI knowledge and to identify factors associated with increased knowledge.


METHODS
A literature review, focus groups with medical students, and local expert interviews were used to develop an electronic survey, which was distributed to all medical students at a single medical school in the spring of 2012.


RESULTS
Fifty-seven percent of the medical school student body (N = 790) participated in the survey. A greater proportion of students reported previous exposure to patient safety education than to QI education (79% vs 47%). Students scored an average of 56% and 58% on the patient safety and QI knowledge tests, respectively. Having or pursuing an advanced degree (P = .02) and previous exposure to patient safety education (P = .02) were associated with higher knowledge scores. After adjusting for confounding variables, only previous exposure to QI education (P = .02) was associated with higher QI knowledge scores.


CONCLUSIONS
There is a risk of measurement bias due to the use of an unvalidated instrument. Students who have greater knowledge of patient safety or QI might recall exposure at a greater frequency, inflating the association between exposure and knowledge. Also, this is a cross-sectional study, so we cannot draw conclusions about causality.


CONCLUSIONS
Medical students' knowledge of patient safety and QI is low. Previous formal or informal education about these topics is associated with increased knowledge.
Corresponding author: Public Health Leadership Program, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Rachel_blasiak@med.unc.edu.
Rachel C
RC
Blasiak
Public Health Leadership Program, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Claire L
CL
Stokes
Public Health Leadership Program, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Karen L
KL
Meyerhoff
Public Health Leadership Program, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Rachel E
RE
Hines
Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Lindsay A
LA
Wilson
Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Anthony J
AJ
Viera
D000328:Adult; D003430:Cross-Sectional Studies; D003479:Curriculum; D004504:Education, Medical, Undergraduate; D004521:Educational Measurement; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009657:North Carolina; D061214:Patient Safety; D058996:Quality Improvement; D013337:Students, Medical / Q000523:psychology*