title: A Spanish-language patient safety questionnaire to measure medical and nursing students' attitudes and knowledge.
abstract: OBJECTIVE
  To design and validate a questionnaire for assessing attitudes and knowledge about patient safety using a sample of medical and nursing students undergoing clinical training in Spain and four countries in Latin America.
  
  
  METHODS
  In this cross-sectional study, a literature review was carried out and total of 786 medical and nursing students were surveyed at eight universities from five countries (Chile, Colombia, El Salvador, Guatemala, and Spain) to develop and refine a Spanish-language questionnaire on knowledge and attitudes about patient safety. The scope of the questionnaire was based on five dimensions (factors) presented in studies related to patient safety culture found in PubMed and Scopus. Based on the five factors, 25 reactive items were developed. Composite reliability indexes and Cronbach's alpha statistics were estimated for each factor, and confirmatory factor analysis was conducted to assess validity. After a pilot test, the questionnaire was refined using confirmatory models, maximum-likelihood estimation, and the variance-covariance matrix (as input). Multiple linear regression models were used to confirm external validity, considering variables related to patient safety culture as dependent variables and the five factors as independent variables.
  
  
  RESULTS
  The final instrument was a structured five-point Likert self-administered survey (the "Latino Student Patient Safety Questionnaire") consisting of 21 items grouped into five factors. Compound reliability indexes (Cronbach's alpha statistic) calculated for the five factors were about 0.7 or higher. The results of the multiple linear regression analyses indicated good model fit (goodness-of-fit index: 0.9). Item-total correlations were higher than 0.3 in all cases. The convergent-discriminant validity was adequate.
  
  
  CONCLUSIONS
  The questionnaire designed and validated in this study assesses nursing and medical students' attitudes and knowledge about patient safety. This instrument could be used to indirectly evaluate whether or not students in health disciplines are acquiring and thus likely to put into practice the professional skills currently considered most appropriate for patient safety.
authors.affiliation: Department of Health Psychology, Universidad Miguel Hernández de Elche, Elche, Spain, jose.mira@umh.es.
authors.forename: José J
authors.initials: JJ
authors.lastname: Mira
authors.affiliation: Department of Economic and Financial Studies, Universidad Miguel Hernández de Elche, Elche, Spain.
authors.forename: Isabel M
authors.initials: IM
authors.lastname: Navarro
authors.affiliation: Department of Health Psychology, Universidad Miguel Hernández de Elche, Elche, Spain, jose.mira@umh.es.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Guilabert
authors.affiliation: Department of Internal Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Poblete
authors.affiliation: Faculty of Public Health, Universidad del Valle, Cali, Colombia.
authors.forename: Astolfo L
authors.initials: AL
authors.lastname: Franco
authors.affiliation: School of Law, Universidad de Salamanca, Salamanca, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Jiménez
authors.affiliation: Hospital de Ninos Benjamín Bloom, San Salvador, El Salvador.
authors.forename: Margarita
authors.initials: M
authors.lastname: Aquino
authors.affiliation: Department of Human Anatomy and Embryology, Universidad de Cádiz, Cádiz, Spain.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Fernández-Trujillo
authors.affiliation: Hospital Universitario Fundación Alcorcón, Madrid, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Lorenzo
authors.affiliation: Department of Public Health, History of Sci-ence and Gynecology, Universidad Miguel Hernández de Elche, Elche, Spain.
authors.forename: Julián
authors.initials: J
authors.lastname: Vitaller
authors.affiliation: Pan American Health Organization, Guatemala City, Guatemala.
authors.forename: Yohana Díaz
authors.initials: YD
authors.lastname: de Valle
authors.affiliation: Department of Public Health, Universidad de Zaragoza, Zaragoza, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Aibar
authors.affiliation: Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors.forename: Jesús M
authors.initials: JM
authors.lastname: Aranaz
authors.affiliation: Universidad de Salamanca, Salamanca, Spain.
authors.forename: José A
authors.initials: JA
authors.lastname: De Pedro
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002489:Central America; D003430:Cross-Sectional Studies; D004521:Educational Measurement; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D061214:Patient Safety; D010865:Pilot Projects; D013020:South America; D013030:Spain; D013337:Students, Medical / Q000523:psychology*; D013338:Students, Nursing / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult