Medical students’ attitudes toward patient safety and medical error reporting in Syria

Patient safety is a core competency in medical education, yet evidence from conflict-affected and low-resource settings remains limited. This study assessed patient safety attitudes among undergraduate medical students in Syria and identified predictors of overall attitudes and error reporting behavior. A multi-center cross-sectional survey was conducted among medical students from four Syrian universities using the Attitudes to Patient Safety Questionnaire-III (APSQ-III). Descriptive statistics, group comparisons, hierarchical regression, and binary logistic regression were performed. Of 1,342 students, the mean APSQ-III score was 4.8 ± 0.67 (positive attitudes). Highest scores were observed for team functioning and working hours as error cause; lowest for professional incompetence as error cause. Although 38.5% witnessed a medical error, only 11.0% reported it. Higher overall attitudes were independently associated with female gender, higher GPA, pre-clinical stage, and having reported an error. Error reporting was predicted by female gender, clinical stage, higher GPA, and higher scores in error reporting confidence and disclosure responsibility. Syrian medical students hold positive patient safety attitudes, but a substantial gap exists in error reporting behavior. Strengthening longitudinal safety education, systems thinking, and supportive non-punitive environments may bridge this gap.