Describe the behaviors of senior students of Medical faculty to express situations that threaten patient safety

Communication breakdowns make significant contributions to medical errors and adverse events in health care. Speak up about patient safety creates a safe atmosphere which is vital to keeping patients safe, preventing errors, and improving the quality of care. Intern doctors are junior medical staff in healthcare institutions, and they experience difficulties in addressing situations that threaten patient safety. This study aims to explore intern doctors' likelihood of speak up for patient safety and identify factors that affect intern doctors' speak up decisions. A qualitative design was used in this study. Purposeful sampling was used as a sampling technique, and a sample of this study consists of nine intern doctors who were enrolled in the 6th Year regular Medical Doctor (MD) program at Hacettepe University Faculty of Medicine in 2017-2018 Spring Semester. Data was collected with face to face semi-structured interviews using semi-structured questions on June 2018. Thematic analysis was used to interpret the data. The results of the study revealed that intern doctors frequently witnessed medical errors during internship and they attempted to speak up at least once before. However, intern doctors are reluctant to speak up about issues that threaten patient safety. Individual, relationship, situational, decision making, consequence related and cultural barriers are preventing intern doctors to speak up. Further, the essential motivator behind the decision to speak up in circumstances that threaten patient safety is feeling empathy for the patient and their relatives. The hierarchical status of the person was decisive in their way of speaking. Interns are supportive and grateful to speak up, and superiors' reactions are often suppressive, sometimes punitive. In line with the results of the research, recommendations were offered at the institutional and national level to improve the records of medical errors, to make arrangements to increase intern doctors' speak up, and to internalize the safety culture of all health care team.