Medical students' situational motivation to participate in simulation based team training is predicted by attitudes to patient safety.
BACKGROUND
Patient safety education, as well as the safety climate at clinical rotations, has an impact on students' attitudes. We explored medical students' self-reported motivation to participate in simulation-based teamwork training (SBTT), with the hypothesis that high scores in patient safety attitudes would promote motivation to SBTT and that intrinsic motivation would increase after training.


METHODS
In a prospective cohort study we explored Swedish medical students' attitudes to patient safety, their motivation to participate in SBTT and how motivation was affected by the training. The setting was an integrated SBTT course during the surgical semester that focused on non-technical skills and safe treatment of surgical emergencies. Data was collected using the Situational Motivation Scale (SIMS) and the Attitudes to Patient Safety Questionnaire (APSQ).


RESULTS
We found a positive correlation between students' individual patient safety attitudes and self-reported motivation (identified regulation) to participate in SBTT. We also found that intrinsic motivation increased after training. Female students in our study scored higher than males regarding some of the APSQ sub-scores and the entire group scored higher or on par with comparable international samples.


CONCLUSIONS
In order to enable safe practice and professionalism in healthcare, students' engagement in patient safety education is important. Our finding that students' patient safety attitudes show a positive correlation to motivation and that intrinsic motivation increases after training underpins patient safety climate and integrated teaching of patient safety issues at medical schools in order to help students develop the knowledge, skills and attitudes required for safe practice.
Department of Clinical Science Intervention and Technology (CLINTEC), Division of Anaesthesia and Intensive Care, Karolinska Institutet, Stockholm, Sweden. cecilia.escher@sll.se.|Center for Advanced Medical Simulation and Training (CAMST), Karolinska University Hospital, Stockholm, Sweden. cecilia.escher@sll.se.
Cecilia
http://orcid.org/0000-0001-7086-7409
C
Escher
Department of Clinical Science Intervention and Technology (CLINTEC), Division of Anaesthesia and Intensive Care, Karolinska Institutet, Stockholm, Sweden.|Center for Advanced Medical Simulation and Training (CAMST), Karolinska University Hospital, Stockholm, Sweden.
Johan
J
Creutzfeldt
Department of Clinical Science Intervention and Technology (CLINTEC), Division of Anaesthesia and Intensive Care, Karolinska Institutet, Stockholm, Sweden.|Center for Advanced Medical Simulation and Training (CAMST), Karolinska University Hospital, Stockholm, Sweden.
Lisbet
L
Meurling
Center for Advanced Medical Simulation and Training (CAMST), Karolinska University Hospital, Stockholm, Sweden.|Department of Psychology, Umeå University, Umeå, Sweden.
Leif
L
Hedman
Center for Advanced Medical Simulation and Training (CAMST), Karolinska University Hospital, Stockholm, Sweden.|Department of Clinical Science Intervention and Technology (CLINTEC), Division of Surgery, Karolinska Institutet, Stockholm, Sweden.
Ann
A
Kjellin
Center for Advanced Medical Simulation and Training (CAMST), Karolinska University Hospital, Stockholm, Sweden.|Department of Clinical Science Intervention and Technology (CLINTEC), Division of Orthopaedics and Biotechnology, Karolinska Institutet, Stockholm, Sweden.
Li
L
Felländer-Tsai
D000328:Adult; D001291:Attitude of Health Personnel; D004504:Education, Medical, Undergraduate / Q000379:methods / Q000592:standards*; D004638:Emergency Treatment / Q000379:methods / Q000592:standards*; D005260:Female; D013502:General Surgery / Q000193:education; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010348:Patient Care Team / Q000458:organization & administration / Q000592:standards; D061214:Patient Safety / Q000592:standards*; D059035:Perioperative Period / Q000009:adverse effects; D011446:Prospective Studies; D000066908:Simulation Training; D013337:Students, Medical / Q000523:psychology*; D013548:Sweden; D055815:Young Adult
Attitudes; Clinical performance; Crew resource management; Medical education; Patient safety; Simulator; Situational motivation; Surgery; Teamwork