Workplace culture affects interns’ safety attitudes

A new study has helped improve intern pharmacists’ safety attitudes… but could that improvement be sustained?

Researchers from the University of Sydney have evaluated the effectiveness of a face-to-face intervention designed to improve current patient safety attitudes among intern pharmacists.

Specifically, the study examined the short- and medium-term effect of intervention in changing interns’ attitudes on four factors: addressing errors; questioning senior healthcare professionals’ behaviours; blaming individuals involved in errors; and reporting errors.

Researchers found a significant improvement in all of these four factors immediately after the intervention.

However, only one of the four factors – blaming individuals – continued to show a significant improvement after three months.

“Three of these items are related to a concept defined by reason as the ‘individual approach to error’, specifically evaluating the use of disciplinary action, believing that competent health care professionals do not make errors and that effective responses to errors should focus primarily on the health care professional involved,” the authors wrote.

“In addition, this factor also consisted of an intern examining interns’ attitudes towards ‘sweeping errors under the carpet,’ where the causes of the incident are not acknowledged.”

While improvement in attitudes towards blaming individuals was sustained, factor scores relating to interns’ attitudes towards addressing errors, questioning behaviours and reporting errors did not show any significant improvement from baseline scores three months after the intervention, the researchers found.

However the authors point out this result is contrary to those seen in other studies of students and early career healthcare professionals, where attitudinal improvements in these three areas were sustained.

While considering several factors influencing this, the researchers suggest that ultimately it is workplace culture and those in senior or managerial positions that have the greatest impact on interns’ attitudes and responses to patient safety issues.

“Furthermore, it was hypothesised that there would be a difference between hospital and community interns’ attitudes to safety, mainly due to many hospitals engaging in patient safety initiatives and that community pharmacy is only starting to be included in patient safety frameworks.

“In this study, however, there were no significant differences between the attitudes of interns based in hospitals or in the community.”

The researchers say the intern period has the greatest impact on the professional socialisation of early career pharmacists and the development of practices and attitudes which will carry them through their careers.

Poor working environments may negatively affect safety attitudes during this time, they say.

“It is therefore necessary that interns be provided with additional mechanisms such as follow-up face-to-face sessions and positive role models and mentors through their intern training programs to enhance attitudinal sustainability and enable generational change.”

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1 Comment

  1. (Mary) Kay Dunkley

    This work is so important! The intern year is crucial to future attitudes to practice. Maybe we need to accredit all intern positions in the same way as the medical profession does.

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