Questionnaire on perceived stress and patient safety awareness

In the absence of valid patient safety competencies assessment tools [23], a questionnaire was designed for perceived stress and awareness of patient safety issues and used during the 10-week clinical rotation. For perceived stress, the Perceived Stress Scale, a widely used validated psychological instrument for assessing the degree to which situations in one’s life are appraised as stressful was used as a basis [24]. We used three questions which were relevant in our context: how often students felt stressed, whether they felt they were able to cope with their tasks, and whether they felt to be in control. In addition, three questions on patient safety awareness were included: whether students had experienced any adverse events, what their own action in response to this event was and to provide an example of events and actions. The reliability of the 3-item reported stress scale (over 10 weeks) was high: 0.92. The reliability of the 2-item reported patient safety behavior scale (over 10-weeks) was good: 0.78.

All six questions related to the preceding week and were filled out on a weekly basis (including examples). Scales were rated from 1 (never) to 5 (very often). High scores indicated high levels of stress or adverse events, questions stated negatively were reversed before analysis (see Additional file 2B for the weekly questionnaire).