Women less confident than men in discussing patient safety with residents, attendings
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Third-year female medical students reported decreased confidence in speaking up about medical errors compared with their male counterparts, according to a presentation at the Women in Medicine Summit.
“In our project, third-year medical students participated in a quality improvement and patient safety course; we want to assess how perceptions of patient safety in medical students can be related to gender,” Sanket Aggarwal, BS, medical student at Rush Medical College, said during the presentation. “We focused on the student's confidence in speaking up about patient harm and their perceived importance of patient safety in medicine.”
For study assessment, 84 third-year medical students (55% men) participated in a patient didactic session. The session was both preceded and succeeded by a 5-point Likert scale survey that assessed patient safety knowledge and focused on a student’s confidence in speaking up about patient harm.
According to study results, 9% and 32% of women participants reported having “significant” or “moderate” prior patient safety experience, respectively, whereas 18% and 45% of men participants reported having “significant” or “moderate” prior patient safety experience. When comparing confidence ratings among women vs. men, they found women were more confident in speaking up about patients’ safety to their peers (3.8 vs. 3.7), but they were less confident in speaking up to their residents (3.1 vs. 3.7) and attendings (2.7 vs. 3.2).
“Students can recognize the importance of patient safety; however, female students reported a lower confidence in approaching residents and attendings regarding patient safety errors,” Christina Brown, BS, medical student at Rush Medical College, said during the presentation. “There could be a couple explanations for why this is; one could be prior patient experience. ... This is a great way to address the gender gap in patient safety. It is our opportunity to empower women in medicine and promote a just culture.”
Perspective
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Maureen Whitsett, MD
In this study, authors sought to understand what, if any, differences existed between male and female medical students in their comfort level and experience in addressing patient safety issues and medical errors. After receiving didactic instruction in patient safety, students then completed a post-intervention survey. When compared to men students, women students reported less frequent prior patient safety experience and reported feeling less confident bringing safety issues to the attention of residents and attendings.
Future directions for researching this topic could include semi-structured interviews with study participants to obtain a better understanding of the challenges trainees face with respect to medical errors and patient safety issues. Another suggestion is to expand beyond the gender binary to be more inclusive of those who identify differently. Further analysis of comfort levels based upon other aspects of student identity such as race, ethnicity or culture may provide a richer understanding of how medical students experience these scenarios. These interviews could provide insight into whether students felt safe and comfortable with members of their team or if they feared repercussions from their supervisors for speaking out about an error.
For trainees to feel comfortable recognizing and reporting safety concerns, they must receive education, encouragement and support. Students should be encouraged to participate in quality improvement initiatives and propose their own solutions to patient safety concerns they encounter on clinical rotations. The delivery of tailored educational interventions and didactics can empower students to effectively communicate and report safety concerns. Education tailored to residents and attendings should reinforce their need to create a team culture which values safety and values the voices and opinions of all members. A training environment where trainees feel safe, respected and valued is crucial for trainees to feel comfortable speaking up about important issues.
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Brown C, et al. Gender differences in patient safety and attitudes of medical students. Presented at: Women in Medicine Summit; Sept. 24-25, 2021 (virtual meeting).
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