Original Research

Final-year medical students’ reflections on types of significant events in primary care

Samantha Dube, Motlatso Mlambo, Nontsikelelo O. Mapukata
African Journal of Primary Health Care & Family Medicine | Vol 15, No 1 | a4099 | DOI: https://doi.org/10.4102/phcfm.v15i1.4099 | © 2023 Samantha Dube, Motlatso Mlambo, Nontsikelelo O. Mapukata | This work is licensed under CC Attribution 4.0
Submitted: 22 March 2023 | Published: 01 November 2023

About the author(s)

Samantha Dube, Department of Family Medicine and Primary Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Motlatso Mlambo, Department of Institutional Intelligence, Portfolio: Strategy, Risk and Advisory Service, University of South Africa, Johannesburg, South Africa
Nontsikelelo O. Mapukata, Department of Family Medicine and Primary Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg Division of Public Health Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa


Background: Adverse events are considered a universal challenge and a burden in the provision of healthcare. For that reason, significant event analysis (SEA) is a critical undertaking in primary health care (PHC), particularly in South Africa where 84% of the population relies on the public health system for their care.

Aim: The study aimed to describe the types of perceived significant events medical students experienced during an integrated primary care block placement.

Setting: Eighteen PHC settings included clinics, community health centres and district hospitals across three provinces in Gauteng, Mpumalanga and the North West.

Methods: Using a qualitative descriptive design with purposeful sampling and maximum variation, structured reflection reports were retrieved from logbooks of final-year medical students studying at a South African university in 2014. Conventional content analysis was used to record the relevant facets of secondary data from 124 logbooks that contained a recording of a significant event using MAXQDA software version 2020.4.

Results: An iterative process revealed three major themes of significant events that were prevalent in PHC settings. These comprised medication and prescription errors, diagnostic errors and suboptimal patient management.

Conclusion: Significant event analysis became a critical quality improvement reflective learning tool. Logbooks offered an opportunity for medical students to explore significant events as a strategic way towards addressing quality and safe practices in PHC settings.

Contribution: This study demonstrated medical students’ ability to identify incidents in the care of patients using the SEA approach and their role in assessing patient safety issues in PHC settings.


adverse events; medical students; patient safety; primary health care settings; significant events analysis

Sustainable Development Goal

Goal 4: Quality education


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