Background and aims A reduction in diagnostic errors is key to patient safety. Paediatric consultants and trainees were surveyed to elicit their perceptions regarding the frequency, contributing factors, and preventative strategies of diagnostic error.

Methods This online survey was pre-tested and administered using SurveyMonkey. Participants were invited to participate by email. Weighted averages of ranked outcomes were computed. Friedman’s test was used to assess non-randomness of ranking.

Results The overall response rate was 38% (n = 310). Respondents included paediatric consultants (31.6%) and trainees (65.9%). 50% of Consultants reported making a diagnostic error at least 1–2 times per quarter, this frequency was significantly higher among trainees (75.9%) (p = 0.027). 36.4% and 29.7% of trainees and consultants respectively reported making a diagnostic error that results in patient harm at least once or twice per year (p = 0.69).

Inadequate staffing levels and/or inexperience of healthcare staff was the most commonly reported system-related factor contributing to diagnostic error. Inadequate data gathering and failing to consider other possible diagnoses were the most common causes of cognitive process breakdown. Excessive workload and physician fatigue were highly ranked additional factors. With regard to reducing diagnostic error, asking for second opinions and increased access to consultants were ranked as the most effective strategies to reduce diagnostic error.

Conclusion This study highlights diagnostic error as a potentially under-recognised patient safety issue. A few key systemic- and cognitive-related factors are identified, while many factors contribute equally to diagnostic error. Further research should focus on methods to instruct clinicians on strategies to reduce recurrence.