Responses of physicians to an objective safety and quality knowledge test: a cross-sectional study

OBJECTIVE: For physicians to practice safe high quality medicine they must have sufficient safety and quality knowledge. Although a great deal is known about the safety and quality perceptions, attitudes and beliefs of physicians, little is known about their safety and quality knowledge. This study tested the objective safety and quality knowledge of practicing US primary care physicians. DESIGN: Cross-sectional objective test of safety and quality knowledge. SETTING: Primary care physicians practicing in the USA. PARTICIPANTS: Study consisted of 518 US practicing primary care physicians who answered an email invitation. Fifty-four percent were family medicine and 46% were internal medicine physicians. The response rate was 66%. INTERVENTION: The physicians took a 24-question multiple-choice test over the internet. OUTCOME: The outcome was the percent correct. RESULTS: The average number of correct answers was 11.4 (SD, 2.69), 48% correct. Three common clinical vignettes questions were answered correctly by 45% of the physicians. Five common radiation exposures questions were answered correctly by 40% of the physicians. Seven common healthcare quality and safety questions were answered correctly by 43% of the physicians. Seven Donabedian’s model of structure, process and outcome measure questions were answered correctly by 67% of the physicians. Two Institute of Medicine’s definitions of quality and safety questions were answered correctly by 19.5% of the physicians. CONCLUSION: Forty-eight per cent of the physicians’ answers to the objective safety and quality questions were correct. To our knowledge, this is the first assessment of the objective safety and quality knowledge of practicing US primary care physicians.