Patient safety knowledge and its determinants in medical trainees

Background: Patient safety is a core educational topic for medical trainees. Objectives: To determine the current level and determinants of patient safety knowledge in medical trainees. Design: Multi-institutional cross-sectional assessment of patient safety knowledge. Participants: Residents and medical students from seven Harvard-affiliated residencies and two Harvard Medical School courses. Measurements: Participants were administered a 14-item validated test instrument developed based on the patient safety curriculum of the Risk Management Foundation (Cambridge, MA). The primary outcome measure was the amount of patient safety knowledge demonstrated by trainees on the validated test instrument. The secondary outcome measure was their subjective perceptions as to their baseline knowledge level in this domain. Results: Ninety-two percent (640/693) of residents and medical students completed the patient safety test. Participants correctly answered a mean 58.4% of test items (SD 15.5%). Univariate analyses show that patient safety knowledge levels varied significantly by year of training (p=0.001), degree program (p < 0.001), specialty (p < 0.001), country of medical school (p=0.006), age (p < 0.001), and gender (p=0.050); all but the latter two determinants remained statistically significant in multivariate models. In addition, trainees were unable to assess their own knowledge deficiencies in this domain. Conclusions: Patient safety knowledge is limited among medical trainees across a broad range of training levels, degrees, and specialties. Effective educational interventions that target deficiencies in patient safety knowledge are greatly needed.