Same behavior, different provider: American medical students' attitudes toward reporting risky behaviors committed by doctors, nurses, and classmates

Abstract

The bioethics literature lacks findings about medical students' attitudes toward reporting risky behaviors that can cause error or reduce the perceived quality of health care. A survey was administered to 159 medical students to assess their likelihood to directly approach and to report various providers-a physician, nurse, or medical student-for three behaviors (poor hand hygiene, intoxication, or disrespect of patients). For the same behavior, medical students were significantly more likely to approach a classmate, followed by a nurse and then a doctor (p < .0001), to ask for behavioral modification. Across all three health care provider types, medical students were most likely to report intoxication (p < .0001). Medical students' willingness to approach or report a provider for a risky or unprofessional behavior is influenced by the type of health care provider in question. Medical schools should implement patient safety curricula that alleviate fears about reporting superiors and create anonymous reporting systems to improve reporting rates.

Assessing Professionalism in Medicine – A Scoping Review of Assessment Tools from 1990 to 2018

“…Likelihood of students to report physicians, nurses and fellow students for unprofessional behaviour 125 Response to case scenarios of ethical issues 18,128 and unprofessional behaviour 131 Demonstration of professional behaviour using clinical vignettes 129 Perception and attitudes of professionalism 24,25,84,88,109,117,130 and professional behaviour 21,76,109 Change in attitudes towards professionalism after professionalism course 25,109,114,117,119 Residents' perceptions of their own professionalism and the professionalism of their learning environment 29 Roberts et al 123 Sang et al 113 x…”

“…• Undergraduate medical school education 18,20,[24][25][26]28,74,80,83,85,96,98,104,106,107,109,111,115,117,119,120,122,[123][124][125][126][127] • graduate medical school education 88 • Postgraduate clinical training 4,[21][22][23]29,30,[76][77][78][79]81,86,90,[93][94][95]97,99,100,102,103,105,108,110,…”

“…• Likert Scale Questionnaire [22][23][24][28][29][30][76][77][78]83,[85][86][87][88]90,[92][93][94]96,97,99,[101][102][103][104][105][106][107]109,110,111,112,[116][117][118][119][120][121][122][124][125][126][127]129 • Frequency of behaviour scale 21,84 • Yes/No questionnaire 76,84 • Checklist 84,115,128 • Multiple-choice questions/responses…”

Is Patient Safety Being Effectively Teached In Medical School?

“…Finally, they highlighted the need for reforms in the medical curriculum in relation to patient safety. The quantitative cross-sectional study conducted 6 with 159 medical students at the University of California, Irvine School of Medicine, assessed, through an electronic survey sent by e-mail to medical students, the likelihood of participants to address and report inappropriate behavior to peers, nurses and doctors. Students were more likely to approach a fellow medical student, followed by nurses, followed by physicians, to ask for behavior modification.…”

“…Another study 4 points out that, for the implementation of the patient safety curriculum, a system and culture where students could report their errors in a comfortable way is necessary. Just as Aggarwal 6 reports that fear of retaliation and fear of being identified were the most common reasons for students not reporting a problem. A study 10 pointed out the need for greater pedagogical engagement in the formal patient safety curriculum in medical education so that the teaching-learning process becomes effective.…”