Patient safety climate and barriers to medication error reporting among nursing students in psychiatric training: A...

To examine the dimension-level network linking patient safety climate and barriers to medication administration error reporting among nursing students in psychiatric clinical training.

Patient safety climate and reporting barriers are important to nursing students' medication safety, but they are often examined separately or as total scores, limiting understanding of dimension-level connections.

A cross-sectional, dimension-level network analysis.

Data were collected from 1565 nursing students undertaking psychiatric clinical internships at a tertiary psychiatric hospital in Chengdu, China, between July 2020 and March 2025. Participants were recruited by convenience sampling and completed an anonymous online questionnaire distributed by teaching coordinators. Patient safety climate was measured using the Safety Climate Scale and reporting barriers were measured using the Barriers to Medication Administration Error Reporting Questionnaire. Dimension-level network analysis was used to identify central and bridge dimensions, with robustness examined using bootstrap and sensitivity analyses.

The network showed two distinct but connected communities: patient safety climate and reporting barriers. The strongest connections were Fear-Face, Training-Worker Safety, Training-Team Positive Attitude and Disagreement over Medication Error-Reporting Effort. Blame, Worker Safety, Fear and Training were among the most central dimensions. Blame and Fear were the main bridge dimensions, followed by Worker Safety and Disagreement over Medication Error.

Patient safety climate and reporting barriers were linked through psychosocial and psychiatric-context-specific dimensions. Findings suggest further development and evaluation of student-oriented reporting policy, just-culture education, psychiatry-specific guidance, worker-safety preparation and structured debriefing. Future studies should evaluate reporting readiness, psychological safety and reporting behaviour.