Storytelling for fostering a culture of safety in healthcare: a quasi-experimental study

Patient safety is a critical component of healthcare, emphasizing the prevention of errors and adverse events that may harm patients during medical care delivery. This study aimed to investigate the impact of storytelling training on patient safety culture amongst nurses at Firuzgar Hospital, affiliated with the Iran University of Medical Sciences, with the objective of minimizing errors in patient care. This quasi-experimental study was conducted at Firouzgar Hospital in 2023. A total of 64 nurses were randomly selected from a population of 515 and allocated into either an intervention group ( n = 32) or a control group ( n = 32) using a computer-generated random number sequence. The intervention group participated in six storytelling sessions, which were conducted by a nurse manager and lasted 1.5 h, over a 3-month period. The stories were derived from the hospital’s own root cause analyses (RCA) and focused on specific patient safety incidents. The control group received only the routine patient safety education provided by the hospital. The safety culture of both groups was assessed using the Hospital Survey on Patient Safety Culture questionnaire (HSOPSC) (version 1) at three timepoints: (1) prior to the intervention (baseline), (2) immediately after the completion of the storytelling sessions and (3) 1 month following the final session. Data were analysed using SPSS software (version 16). Descriptive statistics, independent t -tests, analysis of variance (ANOVA) and Fisher statistical tests were used to compare groups over time. The patient safety culture in the experimental group was significantly higher than that in the control group ( P < 0.001). The effect size of the intervention on patient safety culture was 0.159, indicating a substantial impact, as this value exceeds the threshold of 0.08. The greatest impact was noted in the training and skills dimension (effect size = 0.185), whilst the lowest impact was observed in the staff dimension (effect size = 0.049). This study provides robust evidence that the storytelling intervention based on root cause analysis demonstrated a statistically significant and substantial positive effect on patient safety culture amongst nurses. The intervention was most effective in enhancing the “training and skills” dimension, suggesting its particular value in developing practical competencies. These findings support the use of narrative-based learning as an effective strategy to complement routine patient safety education.