title: Self-reported patient safety competence among Canadian medical students and postgraduate trainees: a cross-sectional survey.
abstract: BACKGROUND
  Quality and patient safety (PS) are critical components of medical education. This study reports on the self-reported PS competence of medical students and postgraduate trainees.
  
  
  METHODS
  The Health Professional Education in Patient Safety Survey was administered to medical students and postgraduate trainees in January 2012. PS dimension scores were compared across learning settings (classroom and clinical) and year in programme.
  
  
  RESULTS
  Sixty-three percent (255/406) of medical students and 32% (141/436) of postgraduate trainees responded. In general, both groups were most confident in their learning of clinical safety skills (eg, hand hygiene) and least confident in learning about sociocultural aspects of safety (eg, understanding human factors). Medical students' confidence in most aspects of safety improved with years of training. For some of the more intangible dimensions (teamwork and culture), medical students in their final year had lower scores than students in earlier years. Thirty-eight percent of medical students felt they could approach someone engaging in unsafe practice, and the majority of medical students (85%) and postgraduate trainees (78%) agreed it was difficult to question authority.
  
  
  CONCLUSIONS
  Our results suggest the need to improve the overall content, structure and integration of PS concepts in both classroom and clinical learning environments. Decreased confidence in sociocultural aspects of PS among medical students in the final year of training may indicate that culture in clinical settings negatively affects students' perceived PS competence. Alternatively, as medical students spend more time in the clinical setting, they may develop a clearer sense of what they do not know.
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ontario, Canada.
authors.forename: Patricia
authors.initials: P
authors.lastname: Doyle
authors.affiliation: School of Nursing and Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ontario, Canada.
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: VanDenKerkhof
authors.affiliation: School of Nursing, Queen's University, Kingston, Ontario, Canada.
authors.forename: Dana S
authors.initials: DS
authors.lastname: Edge
authors.affiliation: School of Health Policy & Management, York University, Toronto, Ontario, Canada.
authors.forename: Liane
authors.initials: L
authors.lastname: Ginsburg
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ontario, Canada.
authors.forename: David H
authors.initials: DH
authors.lastname: Goldstein
mesh_terms: D000328:Adult; D002170:Canada; D002983:Clinical Competence / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data; D008297:Male; D061214:Patient Safety / Q000706:statistics & numerical data*; D057566:Self Report; D013337:Students, Medical / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Graduate medical education; Health professions education; Medical education; Patient safety