Table 5

Likelihood of speaking up in traditional versus professionalism-related patient safety vignettes by level of hierarchy, among all respondents and respondents who perceived high potential for patient harm

All respondents Respondents that perceived high potential for patient harm*
ItemTraditional safety vignette
% (n/N)†
Professionalism vignette
% (n/N)†
p Value‡Traditional safety vignette
% (n/N)
Professionalism vignette
% (n/N)
p Value‡
Would speak up to§
 Nurse89% (747/836)36% (298/836)<0.00194% (286/304)53% (162/304)<0.001
 Intern95% (792/836)55% (460/836)<0.00198% (326/333)70% (232/333)<0.001
 Resident89% (742/836)43% (362/836)<0.00195% (329/347)60% (209/347)<0.001
 Attending64% (537/836)9% (78/836)<0.00171% (179/251)20% (49/251)<0.001
  • *Perceived potential for harm to patients was dichotomised very low/low/moderate (low) versus high/very high (high). In the professionalism vignette (ie, speaking up to an inattentive team member), the number of respondents perceiving a high potential for harm (the denominator) varied by the role of the inattentive team member (ie, nurse, intern, resident and attending physician).

  • †One respondent did not complete all the vignette items (N=836).

  • ‡p Value for McNemar's test comparing within-respondent differences in speaking up in the traditional and professionalism-related safety vignettes.

  • §For our analyses, we categorised very or completely likely to speak up as ‘speaking up’ and not at all, slightly and moderately likely as ‘reticence’.