Reliability and validity of three cultural competency measures (original) (raw)
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Assessment of patient safety culture: what tools for medical students?
BMC Medical Education, 2016
Background: The assessment of patient safety culture refers mainly to surveys exploring the perceptions of health professionals in hospitals. These surveys have less relevance when considering the assessment of the patient safety culture of medical students, especially at university or medical school. They are indeed not fully integrated in care units and constitute a heterogeneous population. This work aimed to find appropriate assessment tools of the patient safety culture of medical students. Methods: Systematic review of the literature. Surveys related to a care unit were excluded. A typology of the patient safety culture of medical students was built from the included surveys. Results: Eighteen surveys were included. In our typology of patient safety culture of medical students (15 dimensions), the number of dimensions explored by survey (n) ranged from 1 to 12, with 6 "specialized" tools (n ≤ 4) and 12 "global" tools (N ≥ 5). These surveys have explored: knowledge about patient safety, acknowledgment of the inevitability of human error, the lack of skills as the main source of errors, the errors reporting systems, disclosure of medical errors to others health professionals or patients, teamwork and patient involvement to improve safety in care. Conclusions: We recommend using Wetzel's survey for making an overall assessment of the patient safety culture of medical students at university. In a specific purpose-e.g. to assess an educational program on medical error disclosure-the authors recommend to determine which dimensions of patient safety will be taught, to select the best assessment tool. Learning on patient safety should however be considered beyond the university. International translations of tools are required to create databases allowing comparative studies.
BMJ quality & safety, 2015
Patient safety (PS) receives limited attention in health professional curricula. We developed and pilot tested four Objective Structured Clinical Examination (OSCE) stations intended to reflect socio-cultural dimensions in the Canadian Patient Safety Institute's Safety Competency Framework. 18 third year undergraduate medical and nursing students at a Canadian University. OSCE cases were developed by faculty with clinical and PS expertise with assistance from expert facilitators from the Medical Council of Canada. Stations reflect domains in the Safety Competency Framework (ie, managing safety risks, culture of safety, communication). Stations were assessed by two clinical faculty members. Inter-rater reliability was examined using weighted κ values. Additional aspects of reliability and OSCE performance are reported. Assessors exhibited excellent agreement (weighted κ scores ranged from 0.74 to 0.82 for the four OSCE stations). Learners' scores varied across the four statio...
Contribution to a Mixed Assessment of Patient Safety Culture
2020
Purpose: The evaluation of patient safety culture is conducted using quantitative methods based on the use of questionnaires and qualitative ones focused on the deployment of cultural maturity models. These methods are known to suffer from certain major limits. This article aims to overcome the difficulties encountered by both methods and to propose a novel approach to the assessment of PSC. Methodology: The approach proposed in this article consists of applying a combined method, based on Principal Component Analysis (PCA) and K-means algorithm, to group together PSC dimensions into macro-dimensions whose exploitation allows to overcome the difficulties encountered with dimensional analysis of PSC and then, serve as a basic support for the development of a patient safety culture maturity model. Findings: The results of the combined method PCA / k-means shows that PSC dimensions can be grouped into three macro-dimensions that were capitalized in a first place using factors related t...
Assessment of Patient Safety and Cultural Competencies among Senior Baccalaureate Nursing Students
International Journal of Environmental Research and Public Health, 2020
This descriptive, correlational, cross-sectional study examined nursing students’ educational experiences on self-reported perceptions of patient safety and cultural competence in terms of curriculum content and learning venues. We performed descriptive analyses and a one-way analysis of variance with a sample of senior-year nursing students (N = 249) attending three state universities in the United States. We used the Nurse of the Future Nursing Core Competency Model, the Patient Safety Competency Self-Evaluation Tool for Nursing Students, and The Cultural Competence Assessment Instrument. Overall, participants reported that patient safety and cultural competencies were addressed in their curricula primarily through classroom activities as opposed to laboratory/simulation or clinical settings. Among the required patient safety knowledge topics, elements of highly reliable organizations were covered the least. For patient safety competency, participants reported higher scores for at...
2021
BACKGROUND: Modern healthcare systems lack empirical models and appropriate tools to evaluate the safety culture, which encourages the need for their development. The national healthcare system of Kazakhstan has no empirically tested robust tools to evaluate the safety culture. AIM: The present paper aims at performing translation, cross-cultural adaptation, and validation of the “Patient safety culture” tool (from here – the tool) as a means for evaluating safety culture in healthcare establishments of the Republic of Kazakhstan. METHODS: The study design was cross-sectional. The original “Patient safety culture” tool is an integrated evaluation framework consisting of 7 scales and 62 items (6 general questions and 56 targeted questions) and reflecting different aspects of risk-related components of safety culture. The Cronbach’s alpha coefficient ranging from 0.0 to 1.0 was used to measure the internal consistency of the tool. To evaluate the tool’s reproducibility, we performed a...
Assessing Patient Safety Culture
Journal of Patient Safety, 2006
Context: Interest in the measurement of organizational culture that supports patient safety has grown among health care providers. Objective: To review available quantitative instruments for the assessment of patient safety culture. Methods: Surveys were identified through a systematic review, which included a MEDLINE and internet search, expert input, and review of references from relevant articles. For each instrument, we examined target populations, number of questions, safety dimensions covered, reliability and validity testing, and ease of use. Results: Our review yielded 13 instruments, covering a total of 23 individual dimensions of patient safety grouped into the broad categories of management/supervision, risk, work pressure, competence, rules, and miscellaneous. The instruments varied substantially in content (number of dimensions addressed), emphasis, and length. Although most of the surveys have substantial face validity, limited validation of the instruments by comparison with qualitative measures of patient safety culture, such as in-depth interviews or observation, has been done, and few data exist on their ability to predict other existing patient safety outcomes or indicators. Questions about how best to analyze and interpret the results remain. Conclusions: The desire to address safety culture in the hope of improving patient safety will continue to motivate researchers and managers to make use of safety culture surveys. Choice of instruments will depend on the intended use, the target population, reliability, validity, and other considerations. An awareness of the differences between the instruments and their collective limitations should facilitate this endeavor.
PATIENT'S SAFETY CULTURE: PRINCIPLES AND APPLICATIONS: REVIEW ARTICLE
This study was conducted to review the literature towards patient's safety culture in terms and applications. Patient's safety is an essential component of healthcare quality. Even with continuous alertness, health care providers face many challenges in today’s health care environment in trying to keep patients safe. Patient's safety is now a required subject that can provide feedback to the healthcare systems with the possibility of implementing improvement measures based on the identification of specific problems. The culture of patient's safety can be analyzed at different levels of the healthcare system, through identifying strengths and weaknesses that configure the way that healthcare professionals think, behave and approach their work. Continuous evolutions in healthcare increase the importance of establishing and maintaining a culture of patient's safety. Therefore research on safety culture is needed to raise awareness about the role of culture in promoting a safer environment. Patient's safety culture examines how the perceptions, behaviors, and competencies of individuals and groups determine an organization’s commitment, style, and proficiency in health and safety management and it is used by organizations to determine targets for interventions to improve patient's safety, evaluate the success of patient's safety interventions, fulfill regulatory requirements, and conduct benchmarking. Patient's safety culture is approached from different perspectives or dimensions such as reporting the frequency and severity of incidents, which so far are not taken into account by hospital staff. In this sense, an ongoing commitment must exist by management to promote and facilitate the culture of patient's safety by providing the necessary tools to identify the most prevalent cultural patterns
Proposal of a Novel Approach to the Assessment of Patient Safety Culture
International Journal of Behavioural and Healthcare Research, 2021
The assessment of Patient Safety Culture (PSC) is often conducted using a quantitative approach based on questionnaires or a qualitative one focused on the deployment of Patient Safety Culture Maturity Models (PSCMM). These two approaches suffer from a number of limitations and their resolution is only possible by exploiting the possible complementarity that exists between them. Indeed, to overcome their inherent limits, it is imperative to merge the two PSC approaches in a single approach called quali-quantitative evaluation of PSC. This article fits into this context and aims to materialise the merger of PSC approaches through their co-deployment. This will make it possible to capitalise the scores of the HSOPSC dimensions in terms of PSC maturity levels.