Year 1 medical undergraduates' knowledge of and attitudes to medical error.

Context: To improve patient safety, medical students should be taught about human error and the factors influencing adverse events. The optimal evaluation of new curricula for patient safety requires tools for baseline measurement of medical students' attitudes and knowledge.

Objectives: The aim of the study was to design and evaluate a questionnaire for measuring the attitudes of Year 1 medical students to patient safety and medical error.

Methods: A questionnaire entitled 'Medical Students' Patient Safety Questionnaire (Year 1)' was designed to assess Year 1 medical students' attitudes and anticipated behaviours relating to medical error and patient safety. This was administered to two cohorts of Year 1 medical students in a UK medical school during 2008 (n = 296) and the data subjected to psychometric analyses.

Results: Medical students' attitudes to good patient safety practices were generally positive, but the students had little knowledge of how to report errors and were unsure about what to do if a colleague made an error or if a patient indicated that an error had been made. On the five scales of the questionnaire, Cronbach's alpha values ranged from 0.59 (Attitudes to patient safety scale) to 0.88 (Knowledge of error and patient safety scale) and three scales showed internal consistencies below the recommended value of 0.70. Exploratory factor analysis showed that the five factors explain 51.7% of variance.

Conclusions: With some minor item trimming and re-allocation, the Medical Students' Patient Safety Questionnaire (Year 1) can function as an instrument with which to assess the attitudes of new medical students to patient safety and medical error. To assess the suitability of the instrument beyond the UK would require additional work.