The Education of Medical Students in Human Factors – A National Survey.
Keywords:Interprofessional education, Medical student, Medical education, Health communication
Introduction: The importance of human factors (HF) has been highlighted recently by the General Medical Council’s decision to include it in their processes for evaluating fitness to practice. Medical school is a vital stage for embedding concepts into medical practice, but little is known regarding the rigor and extent to which HF is taught across UK medical schools.
Methods: An 8-question survey was designed and disseminated nationally using the Qualtrics platform. Respondents were asked for their existing knowledge and perception of HF, education throughout medical school, and relevant demographic factors.
Results: The survey was completed by 304 medical students from 12 UK medical schools. 45.7% of respondents had never heard of HF as a concept. 96.9% of respondents deemed the concept of HF as very important to medicine and future clinical practice. Simulated scenarios, one-to-one and small group teaching emerged as the most effective teaching methods, whilst many students agreed this teaching should take place in the early stages of medical education. Communication and teamwork were perceived to be the most important aspects of HF.
Conclusion: Findings reveal a lack of awareness regarding human factors (HF) among UK medical students. New strategies are needed to ensure the doctors of tomorrow are equipped with the necessary tools to implement and deliver safer, more effective patient care.
Parker SH. Human Factors Science: Brief History and Applications to Healthcare. Curr Probl Pediatr Adolesc Health Care. 2015 Dec 1;45(12):390–4.
International Ergonomics Association. Definition and Domains of Ergonomics [Internet]. 2019 [cited 2019 Nov 13]. Available from: https://www.iea.cc/whats/
Morgan L, Benson D, McCulloch P. Will human factors restore faith in the GMC? BMJ. 2019 Mar 22;l1037.
Cohen D. Back to blame: the Bawa-Garba case and the patient safety agenda. BMJ. 2017 Nov 29;j5534.
Wilmshurst PT. GMC should deal forcefully with repeatedly dishonest doctors. BMJ. 2018 Jan 17;k184.
Rees RN. Criminal and professional sanctions impede honesty and improvement. BMJ. 2018 Jan 17;k172.
Garrouste-Orgeas M, Philippart F, Bruel C, Max A, Lau N, Misset B. Overview of medical errors and adverse events. Ann Intensive Care. 2012 Dec;2(1):2.
Emslie S, Knox K, Pickstone M. Improving patient safety: insights from American, Australian and British healthcare. Based on the proceedings of a joint ECRI and Department of Health Conference to introduce the National Patient Safety Agency. Plymouth, Pa: Emergency Care Research Institute; 2003.
Dornan T, Ashcroft D, Heathfield H, Lewis P, Miles J, Taylor D, et al. An in depth investigation into causes of prescribing errors by foundation trainees in relation to their medical education. EQUIP study. [Internet]. GMC; 2009. Available from: https://www.gmc-uk.org/about/what-we-do-and-why/data-and-research/research-and-insight-archive/causes-of-prescribing-errors-by-foundation-trainees-in-relation-to-their-medical-education
Health Committee. Health Committee - Sixth Report, Patient Safety [Internet]. 2009. Available from: https://publications.parliament.uk/pa/cm200809/cmselect/cmhealth/151/15102.htm
The Joint Commission (Oakbrook Terrace, Illinois), editor. Joint Commission International accreditation standards for hospitals: including standards for academic medical center hospitals. Seventh edition. Oakbrook Terrace: The Joint Commission; 2020.
World Health Organization. Global patient safety action plan 2021–2030: towards eliminating avoidable harm in health care [Internet]. Geneva: World Health Organization; 2021 [cited 2022 Mar 21]. Available from: https://apps.who.int/iris/handle/10665/343477
Gordon M, Parakh D. Medical students’ perceptions of a novel institutional incident reporting system: A thematic analysis. Perspect Med Educ. 2017 Oct;6(5):331–6.
GMC. The State of Medical Education and Practice in the UK [Internet]. 2017. Available from: https://www.gmc-uk.org/about/what-we-do-and-why/data-and-research/the-state-of-medical-education-and-practice-in-the-uk/archived-the-state-of-medical-education-and-practice-in-the-uk-reports
European Parliament and Council of European Union. Regulation (EU) 2016/679 [Internet]. 2016. Available from: https://gdpr-info.eu
The Data Protection Act 2018 [Internet]. Available from: http://www.legislation.gov.uk/ukpga/2018/12/contents/enacted
Qualtrics XM - https://www.qualtrics.com/uk/.
IBM Corp. IBM SPSS Statistics for Windows. Armonk, New York, USA; 2019.
Flin R, Patey R. Improving patient safety through training in non-technical skills. BMJ. 2009 Sep 23;339(sep23 2):b3595–b3595.
Walton M, World Health Organization. Patient safety curriculum guide: multi-professional edition [Internet]. Geneva: World Health Organization; 2011 [cited 2021 Feb 18]. Available from: http://whqlibdoc.who.int/publications/2011/9789241501958_eng.pdf
Bergh A, Van Staden C, Joubert P, Krüger C, Pickworth G, Roos J, et al. Medical students’ perceptions of their development of ‘soft skills’ Part II: The development of ‘soft skills’ through ‘ guiding and growing ’. South Afr Fam Pract. 2006 Sep;48(8):15–15d.
Herron JBT, Ferris C, Gilliam A. Generational and occupational differences in human factors knowledge and awareness: a comparison study. BMJ Mil Health. 2020 Jul 19;bmjmilitary-2020-001487.
Gordon M, Darbyshire D, Baker P. Non-technical skills training to enhance patient safety: a systematic review. Med Educ. 2012 Nov;46(11):1042–54.
Quince T, Abbas M, Murugesu S, Crawley F, Hyde S, Wood D, et al. Leadership and management in the undergraduate medical curriculum: a qualitative study of students’ attitudes and opinions at one UK medical school. BMJ Open. 2014 Jun 25;4(6):e005353–e005353.
GMC. Outcomes for Graduates 2018 [Internet]. Available from: https://www.gmc-uk.org/education/standards-guidance-and-curricula/standards-and-outcomes/outcomes-for-graduates
Chandrashekar A, Mohan J. Preparing for the National Health Service: the importance of teamwork training in the United Kingdom medical school curriculum. Adv Med Educ Pract. 2019 Aug;Volume 10:679–88.
Bromiley M. The Case of Elaine Bromiley [Internet]. Available from: https://emcrit.org/wp-content/uploads/ElaineBromileyAnonymousReport.pdf
Pattni N, Arzola C, Malavade A, Varmani S, Krimus L, Friedman Z. Challenging authority and speaking up in the operating room environment: a narrative synthesis. Br J Anaesth. 2019 Feb;122(2):233–44.
Green B, Oeppen RS, Smith DW, Brennan PA. Challenging hierarchy in healthcare teams – ways to flatten gradients to improve teamwork and patient care. Br J Oral Maxillofac Surg. 2017 Jun;55(5):449–53.
Tofil NM, Morris JL, Peterson DT, Watts P, Epps C, Harrington KF, et al. Interprofessional simulation training improves knowledge and teamwork in nursing and medical students during internal medicine clerkship: Interprofessional IM Simulation Course. J Hosp Med. 2014 Mar;9(3):189–92.
Jorm C, Roberts C, Lim R, Roper J, Skinner C, Robertson J, et al. A large-scale mass casualty simulation to develop the non-technical skills medical students require for collaborative teamwork. BMC Med Educ. 2016 Dec;16(1):83.
Hagemann V, Herbstreit F, Kehren C, Chittamadathil J, Wolfertz S, Dirkmann D, et al. Does teaching non-technical skills to medical students improve those skills and simulated patient outcome? Int J Med Educ. 2017 Mar 29;8:101–13.
Cha JS, Anton NE, Mizota T, Hennings JM, Rendina MA, Stanton-Maxey K, et al. Use of non-technical skills can predict medical student performance in acute care simulated scenarios. Am J Surg. 2019 Feb;217(2):323–8.
Al-Elq A. Simulation-based medical teaching and learning. J Fam Community Med. 2010;17(1):35.
Cousin G. An introduction to threshold concepts. Planet. 2006 Dec;17(1):4–5.
Krathwohl DR. A Revision of Bloom’s Taxonomy: An Overview. Theory Pract. 2002 Nov 1;41(4):212–8.
Meats E, Heneghan C, Crilly M, Glasziou P. Evidence-based medicine teaching in UK medical schools. Med Teach. 2009 Jan;31(4):332–7.
JCST. Surgical Curriculum 2021 [Internet]. 2020. Available from: https://www.iscp.ac.uk/iscp/curriculum-2021/
GMC. Generic professional capabilities framework - General Medical Council. 2017.
Xie A, Carayon P. A systematic review of human factors and ergonomics (HFE)-based healthcare system redesign for quality of care and patient safety. Ergonomics. 2015 Jan 2;58(1):33–49.
Kirch DG, Boysen PG. Changing The Culture In Medical Education To Teach Patient Safety. Health Aff (Millwood). 2010 Sep;29(9):1600–4.
How to Cite
Copyright (c) 2022 Michael Conroy, Joel Chilaka, Gianluca Colucci
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
- Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
- The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
- Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site; with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.
- The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
- Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
- The Author represents and warrants that:
- the Work is the Author’s original work;
- the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
- the Work is not pending review or under consideration by another publisher;
- the Work has not previously been published;
- the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
- the Work contains no libel, invasion of privacy, or other unlawful matter.
- The Author agrees to indemnify and hold Publisher harmless from the Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.
Enforcement of copyright
The IJMS takes the protection of copyright very seriously.
If the IJMS discovers that you have used its copyright materials in contravention of the license above, the IJMS may bring legal proceedings against you seeking reparation and an injunction to stop you using those materials. You could also be ordered to pay legal costs.
If you become aware of any use of the IJMS' copyright materials that contravenes or may contravene the license above, please report this by email to email@example.com
If you become aware of any material on the website that you believe infringes your or any other person's copyright, please report this by email to firstname.lastname@example.org