The Role of Medical Students in Patient Safety: A Qualitative Study

Document Type: Original Article


1 PhD Candidate in Health Services Management, Department of Health Services Management, Semnan Branch, Islamic Azad University, Semnan, Iran

2 Associate Professor, Department of Health Services Management, Semnan Branch, Islamic Azad University, Semnan, Iran 3. Associate Professor, Department of Health Services Administration, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran

3 Associate Professor, Health Economics Policy Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran, Tehran, Iran

4 Associate Professor, Department of Health Services Management, Science and Research Branch, Islamic Azad University, Tehran, Iran


Introduction: Patient safety is one of the main components of health services quality which is defined as the prevention of harm to patients during health care provision. Medical students as members of the treatment team play an important role in patient safety. This study aimed to identify the role of medical students in patient safety in medical centers in Semnan province.
Methods: This applied-qualitative study was carried out using a content analysis approach via the framework analysis method. The participants were key informants and experts of patient safety friendly hospital program. They were selected using purposive sampling and the sampling process continued until the data saturation (n=14). The data were collected via semi-structured interviews and analyzed using MAXQDA software (version 10).
Results: Of 468 primary codes, 6 main codes were extracted including the importance of student education, student participation in teamwork, interaction with patients, medical errors and patient safety threats, standardization of educational processes, and the importance of completing medical documentation.
Conclusion: The results of this study indicated that students have a broad impact on patient safety. Professors and faculty members can improve patient safety and patient satisfaction by interacting with hospital managers, improving the knowledge and clinical capability of medical students, and reducing the impact of negative factors on patient safety.


1. Rajalatchumi A, Ravikumar TS, Muruganandham K, Thulasingam M, Selvaraj K, Reddy MM, et al. Perception of patient safety culture among health-care providers in a tertiary care hospital, South India. J Nat Sci Biol Med 2018; 9(1):14-8. doi: 10.4103/jnsbm.JNSBM_86_17.
2.   Almasi A, Pourmirza Kalhori R, Ahmadi Jouybari T, Godarzi A, Ahmadi A. Evaluation of patient safety culture in personnel of hospitals in Kermanshah, 2013. Journal of Clinical Research In Paramedical Sciences 2015; 4(1):14-23. [In Persian]
3.   Hemmat F, Atashzadeh-Shoorideh F, Mehrabi T, Zayeri F. A survey of nurses' awareness of patient safety culture in neonatal intensive care units. Iran J Nurs Midwifery Res 2015; 20(4):490-5. doi: 10.4103/1735-9066.161003.
4.   Mazhari Z, Adel A. Patient safety status in hospitals of Tehran- patient safety friendly hospitals standards: 2013. Payavard Salamat 2015; 8(5):379-89. [In Persian]
5.   Sharifi S, Izadi-tame A, Hatamipour K, Sadeghigooghary N, Safabakhsh L. Patient safety culture from Mazandaran clinical nurses’ perspective. Iran Journal of Nursing 2014; 27(88):77-87. [In Persian]
6.   Akbari R, Zarei E, Gholami A, Mousavi H. A survey of patient safety culture: a tool for improving patient safety in healthcare providers service organizations. Iran Occupational Health 2015; 12(4): 76-88. [In Persian]
7.   Liao JM, Etchegaray JM, Williams ST, Berger DH, Bell SK, Thomas EJ. Assessing medical students' perceptions of patient safety: the medical student safety attitudes and professionalism survey. Acad Med 2014; 89(2):343-51. doi: 10.1097/ACM.0000000000000124.
8.   Azarabad S, Zaman SS, Nouri B, Valiee S. Frequency, causes and reporting barriers of nursing errors in the operating room students. Research in Medical Education 2018; 10(2):18-27. [In Persian]
9.   Nabilou B, Rasouli J, Khalilzadeh H. Patient safety status in medical education: students perception, knowledg and attitude. Research in Medical Education 2013; 5(2):23-31. [In Persian]
10. Abdi Z, Delgoshaei B, Ravaghi H, Heyrani A. Changing medical students’ knowledge, skills, and attitudes about patient safety. HealthMED 2012; 6(9): 3129-35.
11. World Health Organization. Patient safety curriculum guide for medical schools. [cited 2019 Apr 17] Available from: patientsafety/education/curriculum_guide_medical_schools/en/.
12. Kamran R, Bari A, Khan RA, Al-Eraky M. Patient safety awareness among undergraduate medical students in Pakistani medical school. Pak J Med Sci 2018; 34(2):305-9. doi: 10.12669/pjms.342.14563.
13. Pakzad N, Norouzi Tabrizi K, Fallahi Khoshknab M, Norouzi M. A comparison of the effect of virtual and lecture-based patient safety education on patient safety culture among nurses. Qom University of Medical Sciences Journal 2016; 10(9):27-34. [In Persian]
14. Heyhoe J, Birks Y, Harrison R, O'Hara JK, Cracknell A, Lawton R. The role of emotion in patient safety: are we brave enough to scratch beneath the surface? J R Soc Med 2016; 109(2):52-58. doi: 10.1177/0141076815620614.
15. Jafaei Dalooei R, Karimi Moonaghi H, Yamani N, Irajpoor AR, Saadatyar FS. Interprofessional education: the strategy to improve health care. Research in Medical Education 2015; 7(1):54-62. [In Persian]
16. Kalantari R, Zakerian SA, Mahmodi Majdabadi M, Zanjirani Farahani A, Meshkati M, Garosi E. Assessing the teamwork among surgical teams of hospitals affiliated to social security organizations in Tehran city. Journal of Hospital 2016; 15(3):21-9. [In Persian]
17. Razmara M, Jani M, Moudi A, Sarvari M, Drogar Z, Zolfaghari H, et al. Prioritization of contributing factors on patient safety by analytical hierarchy process. Nursing Management 2016; 5(1):70-8. [In Persian]
18. Arshadi Bostanabad M, Jebreili M, Kargari Rezapour M. Patient safety culture assessment in neonatal intensive care units of tabriz from the perspective of nurses in 2013. Iranian Journal of Nursing Research 2015; 10(3):26-35. [In Persian]
19. Donaghy C, Doherty R, Irwin T. Patient safety: a culture of openness and supporting staff. Surgery (Oxford) 2018; 36(9):509-14. doi:10.1016/j.mpsur.2018.07.005.
20. Hassanzadeh G, Abolhasani F, Mirzazadeh A, Alizadeh M. Team-based learning; a new strategy in integrated medical curriculum: the experience of school of medicine, Tehran University of Medical Sciences. Iranian Journal of Medical Education 2013; 13(7):601-10. [In Persian]
21. Groves PS, Manges KA, Scott-Cawiezell J. Handing off safety at the bedside. Clin Nurs Res 2016; 25(5):473-93. doi: 10.1177/1054773816630535.
22. Lawton R, O'Hara JK, Sheard L, Armitage G, Cocks K, Buckley H, et al. Can patient involvement improve patient safety? A cluster randomised control trial of the Patient Reporting and Action for a Safe Environment (PRASE) intervention. BMJ Qual Saf 2017; 26(8):622-31. doi:10.1136/bmjqs-2016-005570.
23. Wami SD, Demssie AF, Wassie MM, Ahmed AN. Patient safety culture and associated factors: A quantitative and qualitative study of healthcare workers' view in Jimma zone Hospitals, Southwest Ethiopia. BMC Health Serv Res 2016; 16:495. doi: 10.1186/s12913-016-1757-z.
24. Ridelberg M, Roback K, Nilsen P. Facilitators and barriers influencing patient safety in Swedish hospitals: a qualitative study of nurses’ perceptions. BMC Nurs 2014; 13:23. doi: 10.1186/1472-6955-13-23.
25. Abdolmaleki M, Afshar L, Momeni S. Overview on conflict of student and patient's rights in clinical training. Medical Ethics 2014; 8(27):115-27. [In Persian]
26. Akbari M, Taheri L, Momeniyan S, Yosefizadeh F. Relationship of nurses’ mental workload with patient safety condition in emergency departments of Qom University of Medical Sciences Hospitals, 2017. Iranian Journal of Emergency Care 2017; 1(2):67-79. [In Persian]
27. Sarhadi M, Sheikhbardsiri H, Dastras M, Moein H. A Comparative study of barriers to reporting medication errors in nursing students in Zahedan University of Medical Sciences, Iran, in 2013. Journal of Management And Medical Informatics School 2014; 2(1):38-46. [In Persian]
28. Gorgich EA, Barfroshan S, Ghoreishi G, Yaghoobi M. Investigating the causes of medication errors and strategies to prevention of them from nurses and nursing student viewpoint. Glob J Health Sci 2016; 8(8): 54448. doi: 10.5539/gjhs.v8n8p220.
29. Luiz RB, Simoes AL, Barichello E, Barbosa MH. Factors associated with the patient safety climate at a teaching hospital. Rev Lat Am Enfermagem 2015; 23(5):880-7. doi:10.1590/0104-1169.0059.2627.
30. Mostafazadeh F, Asadzadeh F, Rhostamneghad M. Methods of patient safety education for Medical group students. NAIGO 2013; 8(1):23-9. [In Persian]
31. Saberi A, Nemati S, Fakhrieh Asl S, Heydarzadeh A, Fahimi A. Education of medical professionalism and the role of educators of Guilan University of Medical Sciences, Iran, according to its residents. Strides in Development of Medical Education 2013; 10(2):218-24. [In Persian]
32. Farzandipour M, Zahra Meidani Z, Rangraz Jeddi F, Hamidreza Gilasi H, Shokrizadeh Arani L, Mobarak Z. The Effect of educational intervention on medical diagnosis recording among residents in Kashan University of Medical Sciences. Iranian Journal of Medical Education 2012; 12(1):90-8. [In Persian]