Evaluation of defensive medicine practices attitudes and attitudes towards medical errors of clinical branch residents who are receiving specialization training in medicine

Objective: This study aimed to examine the defensive medicine attitudes and attitudes toward medical errors of resident physicians receiving specialty training at Karadeniz Technical University Faculty of Medicine, in relation to residency duration, specialty field, and demographic characteristics. It also sought to determine the potential relationship between defensive medicine attitudes and attitudes toward medical errors. Methods: This descriptive and cross-sectional study was conducted with 185 residents working in clinical departments. Data were collected using the Defensive Medicine Practices Attitude Scale and the Attitudes Toward Medical Errors Scale. Results: The mean age of the 185 participants was 29.0 years, and 52.4% were male. The mean defensive medicine attitude score was 3.32 (± 0.70), with mean positive defensive and negative defensive subscale scores of 3.47 and 3.04, respectively. There were no significant differences in defensive medicine or medical error attitude scores across age, gender, marital status, years of residency (seniority), or specialty group (all p > 0.05). A low positive correlation was found between the perception of medical errors subdimension and defensive medicine attitudes (r ≈ 0.29, p < 0.01), while a weak negative correlation was observed between the approach to medical errors subdimension and defensive medicine attitudes (r ≈ –0.18, p < 0.05). No significant correlations were found between other subdimensions of the Attitudes Toward Medical Errors Scale (general attitude and causes of errors) and defensive medicine scores. Conclusion: The findings indicate that while resident physicians generally exhibit positive awareness regarding medical errors, defensive medical behaviors remain widespread. The perception of errors as a punitive process in clinical settings appears to drive physicians toward defensive practices, leading to reluctance in error disclosure and undermining transparency, trust, and patient safety culture. Therefore, adopting a learning-oriented rather than punitive approach to medical errors, along with implementing structured educational programs on medical errors and patient safety during medical training, is of great importance. Keywords: Defensive Medicine; Medical Error; Medical Malpractice; Resident Physician