BMJ Qual Saf 22:147-154 doi:10.1136/bmjqs-2012-001308
  • Original research

Self-reported patient safety competence among new graduates in medicine, nursing and pharmacy

Open Access
  1. Peter G Norton3
  1. 1School of Health Policy and Management, York University, Toronto, Ontario, Canada
  2. 2School of Nursing, York University, Toronto, Ontario, Canada
  3. 3Department of Family Medicine (Emeritus), University of Calgary, Calgary, Canada
  1. Correspondence to Dr Liane R Ginsburg, School of Health Policy and Management, York University, HNES Bldg Rm 413, 4700 Keele Street, Toronto, Ontario, Canada M3J 1P3; lgins{at}
  • Received 25 June 2012
  • Revised 9 October 2012
  • Accepted 16 October 2012
  • Published Online First 23 November 2012


Background As efforts to address patient safety (PS) in health professional (HP) education increase, it is important to understand new HPs’ perspectives on their own PS competence at entry to practice. This study examines the self-reported PS competence of newly registered nurses, pharmacists and physicians.

Methods A cross-sectional survey of 4496 new graduates in medicine (1779), nursing (2196) and pharmacy (521) using the HP Education in PS Survey (H-PEPSS). The H-PEPSS measures HPs’ self-reported PS competence on six socio-cultural dimensions of PS, including culture, teamwork, communication, managing risk, responding to risk and understanding human factors. The H-PEPSS asks about confidence in PS learning in classroom and clinical settings.

Results All HP groups reported feeling more confident in the dimension of PS learning related to effective communication with patients and other providers. Greater confidence in PS learning was reported for learning experiences in the clinical setting compared with the class setting with one exception—nurses’ confidence in learning about working in teams with other HPs deteriorated as they moved from thinking about learning in the classroom setting to thinking about learning in the clinical setting.

Conclusions Large-scale efforts are required to more deeply and consistently embed PS learning into HP education. However, efforts to embed PS learning in HP education seem to be hampered by deficiencies that persist in the culture of the clinical training environments in which we educate and acculturate new HPs.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: and

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