Patient safety is a new concept worldwide. There are different studies in different countries of the world in this topic. WHO Patient Safety Curriculum Guide: Multi-professional Edition seeks to fill the gap in patient safety education by providing a comprehensive curriculum designed to build foundation knowledge and skills for all health-care students that will better prepare them for clinical practice in a range of environments.⁴ This curriculum guide provides 11 ready to teach patient safety topic. Curriculum for under graduate medical education in Bangladesh updated in 2012 was reviewed to find out these topics. But only minor aspects like the term patient safety, infection prevention, health team concept, doctor patient relationship, and medical ethics were there. But the teaching hour was also inadequate. There was no appropriate assessment plan for these topics. Integration of WHO guidelines had not been done yet. Integration of this into existing curriculum of different countries require appropriate attitude of the health care professional.

Most of the respondents in this study showed a positive attitude toward patient safety. This is similar to PHCC doctors in Aseer region showing a positive attitude toward patient safety.⁸

Regarding their opinion on Patient safety training received. The mean score for this 3 point is 3 to <4 i.e intern doctors have mild positive agreement for the statement. This finding is similar to the findings of Al-Khaldi.⁸

Reporting medical errors is an important step in improving the quality of health‑care including patient safety. Means core of the participants on this item was 3.08 and 3.02. This finding is similar to the findings in other study.⁸ These low scores which reflected the negative attitude of some physicians toward reporting adverse events could be due to the lack of a system for reporting medical errors. Also, a culture of safety in health settings, as reported by Alahmadi is yet to be developed.⁹ As reported by Hammami et al the disclosure of medical errors poses a big dilemma in health settings in Saudi Arabia.¹⁰ In this study 50.4% of the intern doctors agreed to disclose error while 34.3 % disagreed and 15.5% were neutral. In another study, the trend was similar as 44% agreed that ‘‘doctor had the responsibility of disclosing errors to patients only if they resulted in harm to the patient,” while 40% disagreed and 16% were neutral.⁸ A study of medical trainees done by Sorokin found that 80% would disclose adverse events to patients.¹¹ In a study in Italy 44.5% physicians agreed and 44.1% were uncertain about the disclosure of errorstopatient.¹² These diversity of attitude could be explained by the lack of training and experience of physician in dealing with medical errors. In addition, there is a lack of established culture of reporting adverse events by the physician himself in Bangladesh. This finding is similar to the findings in PHC settings in Saudi Arabia.⁸

In this study interns thought shorter shift for doctors would reduce the error. In the few PHCC with a high number of patients attending and work overload, participants showed that a shorter shift for the doctors and taking breaks would reduce medical error.⁸ These findings agree with those reported in 2009 by Carruthers et al.⁷

In this study the area of error inevitability point, most of the intern doctors agreed that even the most experienced can make errors. This area scored positively and is similar to other study. The area of ‘‘errors inevitability” scored 3.97-4.31 points. The finding similar to the findings of Al-Khaldi.⁸ These findings are also comparable to those reported from UK by Carruthers.⁷

Patients play an essential role in their health and safety by active involvement in decision making and self-management.¹³ In this study, intern doctors (77.6%) had positive agreement that patients and relatives had important role in reducing error. Primary health care centre physicians in Aseer region showed average to high agreement (84%) in this regard (4.9 and 5.9 points)⁸ compared to 5.2 points in UK study,⁷ but less than what was reported from Saudi Arabia (44.7%) by Hammami et al.¹⁰

The last theme of the study was about the importance of patient safety in the curriculum. A total of 84.8% of the intern doctors with a high average score of 4.24 out of five points agreed that teaching students about patient safety is a priority in medical training while 87.8% with the highest score of all items in the questionnaire agreed that learning about patient safety before graduation from medical colleges would produce more effective doctors. This finding is similar to Al‑Khaldi which showed 90% and 84% positive response for the two items respectively.⁸ These important findings are also in agreement with results of two studies conducted among medical students in the Qassim region by Almaramhy and Hong Kong by Leung & Patil which emphasized the priority of putting patient safety in the undergraduate curriculum of medical colleges.^14,15 Students regarded patient safety as an important topic that should be included in undergraduate teaching and professional examinations.¹⁵

In this study, 50.5% of intern doctors had no training on patient safety and 58.1 % of them had no training about medical error. In a study in Germany, 79.8% of the respondent had no training on patient safety and 83.2% of the respondent had no training on medical error.⁵ In a study in Aseer region in Saudi Arabia, 70% had not attended any training course on patient safety.⁸ Such important findings indicate that there is urgent need for such interventions as conducting continuous professional development programs on ‘‘medical errors and patient safety” for intern doctors. In spite of the importance of patient safety in the medical curriculum, in this study 76.6% of the intern doctors were not satisfied with their learning or training and they wished more training on patient safety. In a study in Germany, majority of respondents (64%) wished for more education on the issues.⁵

A study by Almaramhy et al mentioned that more than two‑thirds of medical students agreed that the teaching of patient safety in medical schools and the continuous training of health staff was necessary.¹⁴ These findings should alert us on the issue of the curriculum of medical colleges in Bangladesh and the importance of making ‘‘patient safety and medical errors” a priority in the curriculum particularly in final years.

In this study, 41.3 % of intern doctors stated that they had already committed a medical error. In a study by Kiesewetteretal, 25% of the students stated that they already had committed a medical error.⁵ Almost half of the participants reported that they had been assigned to tasks for which they were not trained (52.3%) or where medical errors could have happened easily 57.5%. This finding is similar to the study in Germany conducted by Kiesewetter et al.⁷ which showed 49.7% and 55.5 % respectively.⁵

In this study the intern doctors had positive attitude towards patient safety education. Most of the respondents considered patient safety as a priority topic for undergraduate medical education. Among the intern doctors there was a distinct need for more training in the field of medical error and patient safety. They did not feel sufficiently trained for working as physicians especially in dealing with errors and their communication Existing curriculum was not sufficient for teaching patient safety.