| Factors and items, mean, 95% CI | 1st year P* | 2nd year P** | 3rd year P*** | 1st year P* | 2nd year P** |
| 3rd year P*** |
|
| Working in team | 4.1 (4.0-4.2) | 4.05 (3.93-4.18) | 4.02 (3.90-4.15) | 4.18 (4.07-4.29) | 4.11 (3.99-4.23) |
| 4.22 (4.09-4.35) |
|
| 1. Team dynamics and authority/ power differences | 4.13 (3.99-4.27) | 4.18 (4.04-4.31) | 4.13 (3.99-4.28) | 4.31 (4.18-4.44) | 4.31 (4.18-4.44) |
| 4.40 (4.26-4.54) |
| 2. Managing interprofessional conflicts | 4.10 (3.93-4.27) | 3.99 (3.82-4.16) | 3.88 (3.71-4.05) | 4.10 (3.94-4.26) | 4.02 (3.86-4.18) |
| 4.13 (3.97-4.29) |
| 3. Debriefing and supporting team members after an adverse event/close call | 4.16 (3.99-4.32) | 4.01 (3.82-4.20) | 3.91 (3.74-4.08) | 4.21 (4.04-4.38) | 4.06 (3.88-4.23) |
| 4.22 (4.04-4.41) |
| 4. Sharing authority, leadership, decision-making | 4.14 (3.99-4.28) | 4.16 (4.00-4.31) | 4.10 (3.97-4.23) | 4.13 (3.98-4.29) | 4.20 (4.06-4.34) |
| 4.28 (4.13-4.43) |
| 5. Encouraging team members to speak up, question, challenge, advocate, and be accountable as appropriate to address safety issues | 4.13 (3.97-4.30) | 4.08 (3.91-4.25) | 4.10 (3.97-4.28) | 4.24 (4.08-4.41) | 4.03 (3.85-4.21) |
| 4.13 (3.95-4.32) |
|
| Communicating effectively | 4.38 (4.25- 4.51) | 4.33 (4.18-4.47) | 4.50 (4.27-4.72) | 4.43 (4.27-4.58) | 4.33 0.027 (4.21-4.45) |
| 4.51 (4.38-4.64) |
|
| 6. Enhancing PS through clear and consistent communication with patients | 4.42 (4.28-4.56) | 4.45 (4.31-4.59) | 4.44 (4.32-4.57) | 4.61 (4.48-4.73) | 4.43 (4.30-4.56) |
| 4.52 (4.38-4.66) |
| 7. Enhancing PS through effective communication with healthcare providers | 4.41 (4.28-4.54) | 4.38 (4.23-4.53) | 4.40 (4.27-4.53) | 4.45 (4.31-4.58) | 4.41 (4.29-4.54) |
| 4.54 (4.41-4.68) |
| 8. Effective verbal/nonverbal communication abilities to prevent adverse events | 4.43 (4.16-4.48) | 4.21 (4.06-4.37) | 4.66 (4.01-4.70) | 4.38 (4.22-4.54) | 4.22 (4.08-4.36) |
| 4.48 (4.33-4.66) |
|
| Managing safety risk | 4.12 (3.98-4.25) | 4.19 (4.04-4.34) | 4.27 (4.15-4.38) | 4.18 (4.05-4.31) | 4.07 <0.01 (3.91-4.22) |
| 4.38 <0.01 (4.26-4.51) |
|
| 9. Recognizing routine situations in which safety problems may arise | 4.26 (4.12-4.39) | 4.32 (4.19-4.44) | 4.31 (4.18-4.44) | 4.36 (4.22-4.49) | 4.30 (4.16-4.44) |
| 4.47 (4.33-4.60) |
| 10. Identifying and implementing safety solutions | 4.15 (4.00-4.29) | 4.31 (4.20-4.43) | 4.28 (4.16-4.40) | 4.24 (4.10-4.37) | 4.10 (3.97-4.23) |
| 4.36 (4.22-4.49) |
| 11. Anticipating and managing high- risk situations | 4.06 (3.85-4.26) | 4.18 (4.04-4.32) | 4.22 (4.09-4.35) | 4.06 (3.8-4.26) | 4.02 (3.85-4.19) |
| 4.34 (4.20-4.49) |
|
| Understanding human and environmental factors | 4.21 (4.10-4.33) | 4.18 (4.04-4.31) | 4.27 (4.13-4.40) | 4.36 (4.25-4.47) | 4.27 (4.16-4.38) | <0.01 | 4.48 (4.36-4.60) |
|
| 12. The role of human factors (fatigue) affecting PS | 4.20 (4.05-4.35) | 4.26 (4.09-4.42) | 4.27 (4.10-4.44) | 4.43 (4.30-4.56) | 4.49 (4.35-4.62) |
| 4.41 (4.26-4.56) |
| 13. Safe application of health technology | 4.12 (3.67-4.27) | 4.06 (3.89-4.22) | 4.19 (4.04-4.34) | 4.27 (4.10-4.44) | 4.09 (3.95-4.23) |
| 4.46 (4.31-4.60) |
| 14. The role of environmental factors, such as workflow, ergonomics, and resources, which effect PS | 4.33 (4.18-4.49) | 4.28 (4.15-4.40) | 4.36 (4.21-4.50) | 4.40 (4.24-4.56) | 4.26 (4.12-4.39) |
| 4.41 (4.26-4.56) |
|
| Recognizing and responding to adverse events | 4.12 (4.00-4.24) | 4.16 (4.04-4.28) | 4.25 (4.13-4.37) | 4.19 (4.06-4.32) | 4.06 (3.95-4.18) | <0.01 | 4.27 (4.13-4.41) |
|
| 15. Recognizing an adverse event or close call | 4.16 (4.03-4.28) | 4.19 (4.06-4.32) | 4.32 (4.19-4.45) | 4.18 (4.03-4.33) | 4.16 (4.02-4.29) |
| 4.33 (4.18-4.49) |
| 16. Reducing harm by addressing immediate risks for patients and others involved | 4.16 (4.02-4.29) | 4.19 (4.03-4.35) | 4.27 (4.13-4.40) | 4.31 (4.17-4.46) | 4.08 (3.93-4.22) |
| 4.35 (4.21-4.49) |
| 17. Disclosing an adverse event to the patient | 4.12 (3.95-4.30) | 4.19 (4.04-4.34) | 4.12 (3.96-4.28) | 4.13 (3.96-4.31) | 4.08 (3.83-4.19) |
| 4.17 (3.98-4.35) |
| 18. Participating in timely event analysis, reflective practice, and planning in order to prevent recurrence | 4.07 (3.92-4.21) | 4.13 (3.99-4.28) | 4.30 (4.15-4.45) | 4.16 (3.99-4.32) | 4.03 (3.87-4.20) |
| 4.29 (4.13-4.45) |
|
| Culture of safety | 4.24 (4.14-4.34) | 4.06 (3.86-4.25) | 4.26 (4.09-4.44) | 4.38 (4.28-4.47) | 4.06 (3.88-4.25) | <0.01 | 4.38 (4.21-4.55) |
|
| 19. The ways in which healthcare is complex and has many vulnerabilities | 4.08 (3.93-4.23) | 4.02 (3.86-4.19) | 4.19 (4.05-4.34) | 4.29 (4.13-4.45) | 4.07 (3.91-4.22) |
| 4.36 (4.23-4.50) |
| 20. Having a questioning attitude and speaking up when you see things that may be unsafe | 4.40 (4.26-4.54) | 4.36 (4.21-4.50) | 4.56 (4.43-4.68) | 4.50 (4.39-4.61) | 4.49 (4.37-4.62) |
| 4.69 (4.58-4.80) |
| 21. The importance of a supportive environment encouraging patients and providers to speak up when they have safety concerns | 4.29 (4.16-4.42) | 4.37 (4.21-4.52) | 4.38 (4.22-4.53) | 4.46 (4.33-4.59) | 4.30 (4.15-4.45) |
| 4.51 (4.38-4.65) |
| 22. Systems, system failures, and their role in adverse events | 4.20 (4.04-4.36) | 4.07 (3.91-4.23) | 4.33 (4.18-4.48) | 4.28 (4.11-4.44) | 3.98 (3.82-4.13) |
| 4.36 (4.21-4.51) |
|
| Total | 4.19 (4.11-4.28) | 4.16 (4.06-4.26) | 4.26 (4.16-4.32) | 4.28 (4.20-4.37) | 4.15 (4.07-4.23) | <0.01 | 4.37 (4.27-4.47) |
