Cultura de seguridad del paciente en facultades de odontología: validación de instrumento por participantes

Abstract

Introduction: Patient safety culture is defined as the set of values, attitudes, perceptions, behaviors, and skills of healthcare professionals that contribute to providing safe medical care. Although validated instruments exist to assess this culture in settings such as physicians' offices and hospitals, their application in the academic context, specifically in dental schools, is not always appropriate or directly transferable. Objective: To validate an instrument to assess patient safety culture at the School of Dentistry of Santo Tomás University, Bucaramanga branch. Methods: A questionnaire on patient safety culture in dental schools was designed: instrument validation per participant, composed of 34 theoretical items aimed at measuring patient safety culture in university clinical-dental settings. Content validity was established through expert judgment: five professionals with experience in patient safety and teaching evaluated the items for clarity, coherence, and relevance. Fleiss's Kappa coefficient was calculated, obtaining a value of 0.82, indicating a high level of agreement between raters. The questionnaire was subsequently administered to a purposive sample of 213 participants, including students from the final semesters and staff from the dental clinic at the Bucaramanga branch of Santo Tomás University. Participation was voluntary and anonymous, subject to the signing of informed consent. Results: The internal consistency of the questionnaire was assessed using Cronbach's alpha coefficient, obtaining an overall value of 0.8, indicating good internal reliability of the instrument. This result suggests that the included articles adequately measure aspects related to patient safety culture in the university clinical context. Subsequently, an exploratory factor analysis (EFA) was performed using JASP software. This analysis determined the construct validity of the instrument, considering the criterion of an eigenvalue greater than 1 and minimum factor loadings of 0.3 as the cutoff point for inclusion of items in each factor. As a result, 22 of the 32 items analyzed presented factor loadings greater than 0.3, distributed among six main factors that explain a significant portion of the total variance in the model. These emerging factors were consistent with the originally proposed theoretical dimensions: teamwork, administrative support, organizational learning, adverse event documentation, adequate staffing, and open communication. Conclusions: Validation of a specific instrument for identifying safety culture in dentistry is essential to ensure accurate and relevant measurements in this field. It is advisable to validate the questionnaire with patients and other dental schools. The use of other statistical methods such as the Rasch method is also suggested.