Attitudes toward patient safety culture among respiratory therapy students: an online cross-sectional study in Saudi Arabia

Patient safety culture is a fundamental component of healthcare quality; however, limited evidence exists regarding safety attitudes among respiratory therapy (RT) students. This study aimed to assess the attitudes toward patient safety and identify factors associated with positive safety attitudes among RT students in Saudi Arabia. An online survey using the Safety Attitudes Questionnaire (SAQ) was conducted between August 28 and December 27, 2025. RT students from the second academic year through internship year were recruited using convenience sampling through social media channels. A mean SAQ score of ≥ 75 defined a positive safety attitude. Non-parametric tests were used to compare SAQ scores and multivariable logistic regression was performed to identify factors associated with positive safety attitudes. A total of 1,457 RT students from 18 programs across Saudi Arabia participated in the study, with a mean age of 23 ± 2 years; 68.4% were male. Overall, only 26.9% of RT students demonstrated a positive safety attitude. Male gender (aOR = 1.4, 95% CI: 1.03–1.81) and increasing age (aOR = 1.1, 95% CI: 1.06–1.21) were independently associated with higher odds of positive safety perception. Internship RT students were significantly more likely to report positive safety attitudes compared with second-year RT students (aOR = 3.0, 95% CI: 1.10–7.98). Significant regional disparities were observed, with RT students from the Southern, Northern, and Central regions demonstrating higher odds of positive safety perception compared with those from the Eastern region. Higher cumulative GPA was also strongly associated with positive safety attitudes, particularly among RT students with GPAs ≥ 4.00. Safety attitudes among RT students in Saudi Arabia remain suboptimal, highlighting the need to strengthen patient safety education during professional training.