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Acad Med. 2018 May 15. doi: 10.1097/ACM.0000000000002286. [Epub ahead of print]

The Relationship Between the Learning and Patient Safety Climates of Clinical Departments and Residents' Patient Safety Behaviors.

Author information

1
M.E.W.M. Silkens is scientific researcher, Professional Performance Research Group, Department of Medical Psychology, Academic Medical Center/University of Amsterdam, Amsterdam, the Netherlands. O.A. Arah is professor, Department of Epidemiology, Fielding School of Public Health, and faculty associate, Center for Health Policy Research, University of California, Los Angeles, Los Angeles, California. C. Wagner is executive director, the Netherlands Institute for Health Services Research, Utrecht, the Netherlands, and professor in patient safety, VU Medical Center, Amsterdam, the Netherlands. A.J.J.A. Scherpbier is professor, Department of Educational Development and Research, and dean, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, the Netherlands. M.J. Heineman is professor, Department of Obstetrics and Gynecology, Academic Medical Center, and vice dean, Faculty of Medicine, Academic Medical Center/University of Amsterdam, Amsterdam, the Netherlands. M.J.M.H. Lombarts is professor, Professional Performance Research Group, Department of Medical Psychology, Academic Medical Center/University of Amsterdam, Amsterdam, the Netherlands.

Abstract

PURPOSE:

Improving residents' patient safety behavior should be a priority in graduate medical education to ensure the safety of current and future patients. Supportive learning and patient safety climates may foster this behavior. This study examined the extent to which residents' self-reported patient safety behavior can be explained by the learning climate and patient safety climate of their clinical departments.

METHOD:

The authors collected learning climate data from clinical departments in the Netherlands that used the web-based Dutch Residency Educational Climate Test between September 2015 and October 2016. They also gathered data on those departments' patient safety climate and on residents' self-reported patient safety behavior. They used generalized linear mixed models and multivariate general linear models to test for associations in the data.

RESULTS:

In total, 1,006 residents evaluated 143 departments in 31 teaching hospitals. Departments' patient safety climate was associated with residents' overall self-reported patient safety behavior (regression coefficient (b) = 0.33; 95% confidence interval (CI) = 0.14 - 0.52). Departments' learning climate was not associated with residents' patient safety behavior (b = 0.01; 95% CI = -0.17 - 0.19), although it was with their patient safety climate (b = 0.73; 95% CI = 0.69 - 0.77).

CONCLUSIONS:

Departments should focus on establishing a supportive patient safety climate to improve residents' patient safety behavior. Building a supportive learning climate might help to improve the patient safety climate and, in turn, residents' patient safety behavior.

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