All and strongly disagreed’ were together reported as ‘disagreed’.

All 519 participants responded.

For the purpose ofreporting we combined the responses of ‘agreed’ and ‘strongly agreed’ to reportthem as ‘agreed’, while ‘disagreed’ and strongly disagreed’ were togetherreported as ‘disagreed’. In the following summary our findings, for easeof presentation, the term “majority” was defined as “greater than 50% ofrespondents”.  Items 1 to 4 were aimed at addressing students’knowledge regarding medical errors. Medical error is a complex issue, but erroritself is an inevitable part of the patient condition.

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However, it can beavoided. To achieve this, medical students must learn from past errors, andlearn how to prevent future errors (WHO, 2009). Although majority of students were correct in thinkingthat medical errors are inevitable, about a quarter neutral with this andapproximately 13% remained disagree. By giving the teaching of patient safetyeven in short lecture, the student awareness about inevitable of medical error willimprove (Leung, 2010). Half agreed that best care is not always provided topatients (263; 50.67%). The results were similar to the findings of Leung(2010), Shah (2015), and Nabilou (2015).

Majority of students thought competentphysicians do not make errors (391; 75.34%). For item 4, a significant numberof students thought most errors are not related to physicians (249; 47.

98%) andthis misconception was more among preclinical students (212; 51.08%) than clinicalstudents (37; 35.58%) (p value =0.

006) (Table-2). The concernsof patient safety are worldwide, and it is widely recognized that medical errors,adverse events, and near miss events are considerably underreported. Items 5 to8 were related to perceptions about reporting of medical errors (Table 1).

Itwas encouraging that majority of students thought medical errors should bereported (306; 58.96%) and moreover they said there is need to report a nearmiss event (380; 73.22%) thus will have a chance to learn from those cases. Medicalcommunity may not want a doctor especially medical student to speak in view ofthe risk of litigation, and also to remain quiet and defend other doctors whomake mistakes.

By learn fromerror, student will realize that blaming people does not work, and that ifpeople fear being blamed no one will report or learn from the event. Reportingincidents and adverse events is also a systematic way of gathering informationabout the safety and quality of care. Almost half numberof students disagreed that only physicians can determine the causes of medicalerror (249; 47.98%). Medical error occur not because patients intentionallyhurt by bad people but rather that the system of health care today is socomplex that the successful treatment and outcome for each patient depends on manyfactors, not just the competence of physicians. When so many people and differenttypes of health-care providers (doctors, pharmacists, nurses, laboratory staffsand others) are involved this makes it very difficult to ensure safe care,unless the system of care is designed to facilitate timely and complete informationand understanding by all the health professionals.  More than one-third students thought reporting systemswill reduce medical errors (205; 39.5%).

An incident-reporting system is animportant component of an organization’s ability to learn from error. Most ofhealth facilities e.g. hospitals will have a reporting system to identifyadverse events. It is important that students are aware of these events. Studentsshould seek information on the reporting system used in the hospital where theyare practicing or placed. Students should be familiar with the system in placeand seek information about how to report an incident.  The vastmajority agreed that errors can be prevented by working hard and being morecareful (490; 94.

41%). In contrary, evidence shows that thetraditional “perfectibility” model which assumed that errors can be avoidedby being careful enough and working hard can be dangerous as the major contributingfactor for adverse events is the human.    Near half saidthat uncertainty should not be tolerated in patient care and culture ofmedicine was supportive for dealing with errors (257; 49.52 %). They need tounderstand the culture of their workplace, and how it impacts upon team functioning.

Discussions about medical errors are difficult for doctors in all cultures.Openness to learning from errors will often depend on the personalities of the seniorpeople. In some cultures and hospitals, openness about errors may be new and soit will be very difficult for doctors.

In these cases, it may be appropriatefor the students to talk about errors in a student teaching session.