Assessment of patient safety culture: what tools for medical students?
BACKGROUND
The assessment of patient safety culture refers mainly to surveys exploring the perceptions of health professionals in hospitals. These surveys have less relevance when considering the assessment of the patient safety culture of medical students, especially at university or medical school. They are indeed not fully integrated in care units and constitute a heterogeneous population. This work aimed to find appropriate assessment tools of the patient safety culture of medical students.


METHODS
Systematic review of the literature. Surveys related to a care unit were excluded. A typology of the patient safety culture of medical students was built from the included surveys.


RESULTS
Eighteen surveys were included. In our typology of patient safety culture of medical students (15 dimensions), the number of dimensions explored by survey (n) ranged from 1 to 12, with 6 "specialized" tools (n ≤ 4) and 12 "global" tools (N ≥ 5). These surveys have explored: knowledge about patient safety, acknowledgment of the inevitability of human error, the lack of skills as the main source of errors, the errors reporting systems, disclosure of medical errors to others health professionals or patients, teamwork and patient involvement to improve safety in care.


CONCLUSIONS
We recommend using Wetzel's survey for making an overall assessment of the patient safety culture of medical students at university. In a specific purpose-e.g. to assess an educational program on medical error disclosure-the authors recommend to determine which dimensions of patient safety will be taught, to select the best assessment tool. Learning on patient safety should however be considered beyond the university. International translations of tools are required to create databases allowing comparative studies.
Health Services and Performance Research (HESPER), 162 Avenue Lacassagne Bât A-F69424, Lyon, cedex 03, France. marc.chaneliere@univ-lyon1.fr.|Claude Bernard University Lyon 1 (UCBL), 8 avenue Rockefeller, F 69373, Lyon, Cedex 08, France. marc.chaneliere@univ-lyon1.fr.|Hospices Civils de Lyon, Pôle IMER, 162 Avenue Lacassagne Bât A-F69424, Lyon, cedex 03, France. marc.chaneliere@univ-lyon1.fr.|Department of Family Practice-UCB Lyon, 1 - 8 av Rockefeller 69373, Lyon, cedex 08, France. marc.chaneliere@univ-lyon1.fr.
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M
Chaneliere
Claude Bernard University Lyon 1 (UCBL), 8 avenue Rockefeller, F 69373, Lyon, Cedex 08, France.
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F
Jacquet
Claude Bernard University Lyon 1 (UCBL), 8 avenue Rockefeller, F 69373, Lyon, Cedex 08, France.|Hospices Civils de Lyon, Pôle IMER, 162 Avenue Lacassagne Bât A-F69424, Lyon, cedex 03, France.
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Occelli
Claude Bernard University Lyon 1 (UCBL), 8 avenue Rockefeller, F 69373, Lyon, Cedex 08, France.|Hospices Civils de Lyon, Pôle IMER, 162 Avenue Lacassagne Bât A-F69424, Lyon, cedex 03, France.
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S
Touzet
Health Services and Performance Research (HESPER), 162 Avenue Lacassagne Bât A-F69424, Lyon, cedex 03, France.|Claude Bernard University Lyon 1 (UCBL), 8 avenue Rockefeller, F 69373, Lyon, Cedex 08, France.
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V
Siranyan
Health Services and Performance Research (HESPER), 162 Avenue Lacassagne Bât A-F69424, Lyon, cedex 03, France.|Claude Bernard University Lyon 1 (UCBL), 8 avenue Rockefeller, F 69373, Lyon, Cedex 08, France.|Hospices Civils de Lyon, Pôle IMER, 162 Avenue Lacassagne Bât A-F69424, Lyon, cedex 03, France.
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C
Colin
Assessment; Medical student; Patient safety culture; Survey
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