Patient safety culture among medical students in Singapore and Hong Kong

Abstract

Undergraduate education plays an important role in promoting patient safety. Students from different backgrounds may differ in their perceptions towards patient safety. We investigated whether and how patient safety cultures may differ between students from different countries. We used a validated instrument, the ‘Attitudes to Patient Safety Questionnaire (APSQ)-III’, to study two cohorts of second-year medical students from Singapore (SG) and Hong Kong (HK). None had received any previous teaching on patient safety. The APSQ-III consisted of 26 items covering nine key patient safety factors. The responders included 81 (31.3%) students from HK and 178 (68.7%) from SG. The overall response rate was 66.4%. Significant differences were found in two key factors – students from HK were more likely to report having more patient safety training (P = 0.007) whereas SG students reported less confidence in error disclosure (P < 0.001). Both groups considered medical error as inevitable, and that long working hours and professional incompetence were important causes of medical errors. The importance of patient involvement and team functioning received relatively less emphasis. In summary, The APSQ-III could identify differences in patient safety cultures and possibly teaching needs amongst students from different medical schools. Students with no prior teaching on the subject may differ in their self-efficacy possibly due to underlying differences between their local cultures and healthcare environments. Patient safety teaching should be tailored to students’ perceptions and needs, and longitudinally studies using a validated instrument may help to design and evaluate teaching programs.