A novel approach to patient safety education: integrating the human factors analysis and classification system (HFACS) to build a culture of safety in medical training

Abstract Background This study evaluated the effectiveness of an educational intervention based on the Human Factors Analysis and Classification System (HFACS) in enhancing medical students’ patient safety competencies. The intervention specifically targeted students’ ability to identify human factors and recognize adverse events. Methods A quasi-experimental pre–post study was conducted at Shin Kong Wu Ho-Su Memorial Hospital in Taiwan. Forty medical students from two medical schools were recruited; 38 completed both pre- and post-tests for adverse event recognition, and 30 completed both assessments for human factors identification. The 90-minute HFACS-based workshop included theoretical instruction, video-based simulations, and case discussions. Validated questionnaires and structured video analyses were used to evaluate students’ competencies before and after the intervention. Paired t -tests were conducted to assess changes. Results The intervention significantly improved students’ patient safety competencies. Recognition of reportable adverse events increased from 73.4% (SD = 17.0) to 94.0% (SD = 2.9), p < 0.001, Cohen’s d = 1.3, 95% CI: 0.15–0.26. Awareness of the importance of reporting rose from 63.9% (SD = 17.2) to 80.4% (SD = 7.8), p < 0.001, d = 0.9, 95% CI: 0.10–0.23. The total number of identified human factors increased from 5.5 (SD = 2.4) to 36.7 (SD = 14.1), p < 0.001, d = 2.1, with significant improvements observed across all four HFACS levels. Conclusions The HFACS-based educational intervention significantly enhanced medical students’ competencies in recognizing adverse events, understanding the importance of reporting, and identifying human factors across multiple system levels. These findings support the integration of HFACS into medical curricula to promote systemic thinking and foster a proactive safety culture.