PATIENT SAFETY

Background: Patient safety is a fundamental pillar of healthcare quality, yet preventable adverse events contribute significantly to global morbidity and mortality, particularly in resource-limited settings. Clinical students actively participate in patient care, making their understanding and practice of safety principles critical to preventing institutional errors. Objective: This study assessed the knowledge and attitudes regarding patient safety and evaluated the patient safety culture (PSC) practices among clinical students at the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria. Methodology: A cross-sectional, mixed-methods study was conducted between April 2025 and April 2026 among 637 clinical students across five disciplines (Medicine, Nursing, Medical Laboratory Science, Physiotherapy, and Paramedics) selected via stratified random sampling. Quantitative data were collected using a modified questionnaire adapted from the World Health Organization (WHO) and the Agency for Healthcare Research and Quality (AHRQ), while qualitative data were gathered via Focus Group Discussions (FGDs). Quantitative data were analyzed using IBM SPSS version 27.0, employing descriptive statistics, bivariate analysis, and binary logistic regression. Qualitative transcripts underwent thematic analysis. Results: The mean age of the respondents was 23.41 \pm 2.08 years, with a slight female predominance (52.1%). A significant majority (75.0%) possessed good overall knowledge of patient safety principles, with the highest domain scores in the systems view of errors (84.3%). Moving to the senior 600 level (AOR: 2.370, p = 0.045) and receiving prior formal x safety training (AOR: 1.850, p = 0.004) were independent predictors of good knowledge. Conversely, spending >12 hours a day in the hospital nearly halved the odds of maintaining good knowledge (AOR: 0.534, p = 0.031). Attitudes were overwhelmingly favorable, with 91.2% demonstrating a positive mindset, which strongly associated with higher cognitive scores (p = 0.004). However, actual patient safety culture practice fell dramatically short, with 73.8% of participants exhibiting poor overall practice. Only 19.5% had ever filed a formal incident report. Among the 513 students who never filed a report, the primary barriers identified were fear of victimization or blame (58.0%), strict institutional hierarchies (44.3%), and high workloads (42.0%). Key curricular and experiential gaps identified included an absolute lack of formal instruction in root cause analysis (59.0%) and incident reporting protocols (49.3%). Conclusion: Clinical students at UBTH display robust theoretical knowledge and highly positive attitudes toward patient safety responsibilities, but institutional, systemic, and cultural barriers significantly impede the translation of these attributes into safe clinical practices. Addressing this disconnect requires aggressive educational reforms, such as integrating simulation-based learning into clinical rotations, and structural interventions by hospital management to establish a accessible, transparent, and non-punitive incident reporting environment.