The Education of Medical Students in Human Factors – A National Survey
Keywords:Interprofessional education, Medical education, Health communication, Medical Students
Background: 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 vital for embedding concepts into medical practice, but little is known about the rigor and extent to which HF is taught across United Kingdom (UK) medical schools.
Methods: Cross-sectional study assessing HF among medical students in the UK. 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. In total, 45.7% of respondents had never heard of HF as a concept. Furthermore, 96.9% of respondents deemed the concept of HF as very important to medicine and future clinical practice. Moreover, simulated scenarios, one-to-one and small group teaching emerged as the most effective teaching methods, whilst many students agreed this teaching should occur in the early stages of medical education. Lastly, communication and teamwork were perceived to be the most important aspects of HF.
Conclusion: These findings reveal a lack of awareness regarding 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;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;364:l1037.
Cohen D. Back to blame: the Bawa-Garba case and the patient safety agenda. BMJ. 2017;359:j5534.
Wilmshurst PT. GMC should deal forcefully with repeatedly dishonest doctors. BMJ. 2018;360:k184.
Rees RN. Criminal and professional sanctions impede honesty and improvement. BMJ. 2018;360: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;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]. 2019 [cited 2009 Nov 13]. 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;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-
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. Available from: 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;339: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;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;bmjmilitary-2020-001487.
Gordon M, Darbyshire D, Baker P. Non-technical skills training to enhance patient safety: a systematic review. Med Educ. 2012;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;4(6):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;10:679–88.
Bromiley M. The Case of Elaine Bromiley [Internet]. Available from: https://emcrit.org/wpcontent/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;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;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;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;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;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;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;17(1):4–5.
Krathwohl DR. A Revision of Bloom’s Taxonomy: An Overview. Theory Pract. 2002;41(4):212–8.
Meats E, Heneghan C, Crilly M, Glasziou P. Evidence-based medicine teaching in UK medical schools. Med Teach. 2009;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;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.
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