UWindsor nursing study shows trust and mentorship are key to medication incident reporting

Faculty of Nursing professor Natalie Giannotti led a study examining perceptions of medication incident reporting,

helping advance a culture of patient safety, learning, and transparency. (SUBMITTED BY NATALIE GIANNOTTI/University of Windsor)

Administering medication may appear straightforward, but behind every dose is a complex series of steps where errors can still occur despite the best intentions of health-care professionals.

Nearly two decades after introducing a medication incident reporting system for nursing students, the University of Windsor is seeing evidence that its efforts to build a culture of safety are taking hold.

A new study led by Dr. Natalie Giannotti, a professor in the Faculty of Nursing, explores how nursing students and instructors perceive medication incident reporting and the culture surrounding it.

"We wanted to see how far along we've come and whether we've established the culture of safety we thought we had," Giannotti said. "If there are still barriers, we want to know how we can overcome them."

The reporting system reflects principles that emerged from the modern patient safety movement, which drew important lessons from high-risk industries such as aviation. Aviation demonstrated the value of non-punitive incident reporting and learning from errors to strengthen systems rather than assign blame.

Building on these principles, the Faculty of Nursing introduced its medication incident reporting system in 2009 to help students recognize, report and learn from medication incidents.

Today, the reporting process is fully integrated throughout the undergraduate curriculum.

Students use a customized reporting system to document medication errors, near misses, discovered errors made by others and practice incidents. Trends and significant findings are shared with clinical partners to help identify opportunities for improvement. The process also shows students how reporting can strengthen patient safety and influence positive change across the health-care system.

One of the study's strongest findings was that students experience safety culture through people, not policies.

Although the Faculty of Nursing has established reporting processes and expectations, students said their willingness to report incidents was shaped largely by interactions with clinical instructors.

"When they have supportive instructors, they're much more inclined to report," Giannotti said. "Students don't experience safety culture as a policy document. They experience it through conversations."

The research also showed that a supportive culture and fear can exist at the same time.

While many students viewed reporting positively and understood its importance, they still expressed concerns about judgment, criticism or potential academic consequences.

“The emotional and relational environment matters,” she said. “Students repeatedly talked about the importance of mentoring and the importance of being able to debrief.”

These findings reinforce the Faculty of Nursing's commitment to fostering a just culture — one that recognizes medication incidents and near misses as opportunities to understand why events occur and how systems can be improved, rather than assigning individual blame. Through reflection, mentorship and open dialogue, the reporting process helps students identify contributing factors and strengthen their clinical judgment, ultimately improving patient safety.

Students also help shape that culture through the Medication and Patient Safety Advisory Committee, where they work alongside faculty members to develop patient safety resources and initiatives for their peers.

The study's findings are being prepared for publication, and the faculty plans to share the reporting model with nursing programs across Canada, extending the University’s leadership in patient safety education.

"The goal is to create a new generation of leaders who put patient safety first," Giannotti said. "We're helping students develop the confidence, skills and voice to identify risks, speak up and help build safer systems for everyone."

By Sara Meikle

Courtesy: https://www.uwindsor.ca/news/2026-07-14/uwindsor-nursing-study-shows-trust-and-mentorship-are-key-medication-incident-reporting