How trainees would disclose medical errors: educational implications for training programmes
Medical Education 2011: 45: 372–380 Objectives The disclosure of harmful errors to patients is recommended, but appears to be uncommon. Understanding how trainees disclose errors and how their practices evolve during training could help educators design programmes to address this gap. This study wa...
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| Veröffentlicht in: | Medical education 2011-04, Vol.45 (4), p.372-380 |
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| creator | White, Andrew A Bell, Sigall K Krauss, Melissa J Garbutt, Jane Dunagan, W Claiborne Fraser, Victoria J Levinson, Wendy Larson, Eric B Gallagher, Thomas H |
| description | Medical Education 2011: 45: 372–380
Objectives The disclosure of harmful errors to patients is recommended, but appears to be uncommon. Understanding how trainees disclose errors and how their practices evolve during training could help educators design programmes to address this gap. This study was conducted to determine how trainees would disclose medical errors.
Methods We surveyed 758 trainees (488 students and 270 residents) in internal medicine at two academic medical centres. Surveys depicted one of two harmful error scenarios that varied by how apparent the error would be to the patient. We measured attitudes and disclosure content using scripted responses.
Results Trainees reported their intent to disclose the error as ‘definitely’ (43%), ‘probably’ (47%), ‘only if asked by patient’ (9%), and ‘definitely not’ (1%). Trainees were more likely to disclose obvious errors than errors that patients were unlikely to recognise (55% versus 30%; p |
| doi_str_mv | 10.1111/j.1365-2923.2010.03875.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3501535</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>863770181</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4935-35e7e15545cda5e65e6f41fc6e3f33c99e75a4719220f1bd9657fd28ed6fa2b33</originalsourceid><addsrcrecordid>eNpVkW9rFDEQxoMo9lr9CpI34qu9JptNNusLQc7-g6oILYIIIZednDmzm2ty612_fbO986ohkMzMw2-GeRDClExpPqfLKWWCF2VTsmlJcpYwWfPp9hmaHArP0YQwIgtCKTlCxyktCSE1r-RLdFTSilAh-QT9vAwbvI7a9QAJb8LgW9y6ZHxIgDtondEeQ4whpvcY2sHotQt9zrlu5d0uStiGuIO4foFXMSyi7jpIr9ALq32C1_v3BN2en93MLovrrxdXs4_XhakaxgvGoQbKecVNqzmIfG1FrRHALGOmaaDmuqppU5bE0nnbCF7btpTQCqvLOWMn6MOOuxrmeWYDfR7Gq1V0nY73Kmin_q_07pdahD-KcUI54xnwbg-I4W6AtFZd3gF4r3sIQ1JSsLomVNKsfPNvq0OPvxvNgrd7gU55dzbq3rj0pGNNJSkRTzNvnIf7Q50SNTqslmo0Uo1GqtFh9eiw2qrPZ59ux28GFDuAS2vYHgA6_laiZln7_cuFYrNvcnaTgx_sAY5zqyg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>863770181</pqid></control><display><type>article</type><title>How trainees would disclose medical errors: educational implications for training programmes</title><source>MEDLINE</source><source>Wiley Journals</source><source>EBSCOhost Education Source</source><creator>White, Andrew A ; Bell, Sigall K ; Krauss, Melissa J ; Garbutt, Jane ; Dunagan, W Claiborne ; Fraser, Victoria J ; Levinson, Wendy ; Larson, Eric B ; Gallagher, Thomas H</creator><creatorcontrib>White, Andrew A ; Bell, Sigall K ; Krauss, Melissa J ; Garbutt, Jane ; Dunagan, W Claiborne ; Fraser, Victoria J ; Levinson, Wendy ; Larson, Eric B ; Gallagher, Thomas H</creatorcontrib><description>Medical Education 2011: 45: 372–380
Objectives The disclosure of harmful errors to patients is recommended, but appears to be uncommon. Understanding how trainees disclose errors and how their practices evolve during training could help educators design programmes to address this gap. This study was conducted to determine how trainees would disclose medical errors.
Methods We surveyed 758 trainees (488 students and 270 residents) in internal medicine at two academic medical centres. Surveys depicted one of two harmful error scenarios that varied by how apparent the error would be to the patient. We measured attitudes and disclosure content using scripted responses.
Results Trainees reported their intent to disclose the error as ‘definitely’ (43%), ‘probably’ (47%), ‘only if asked by patient’ (9%), and ‘definitely not’ (1%). Trainees were more likely to disclose obvious errors than errors that patients were unlikely to recognise (55% versus 30%; p < 0.01). Respondents varied widely in the type of information they would disclose. Overall, 50% of trainees chose to use statements that explicitly stated that an error rather than only an adverse event had occurred. Regarding apologies, trainees were split between conveying a general expression of regret (52%) and making an explicit apology (46%). Respondents at higher levels of training were less likely to use explicit apologies (trend p < 0.01). Prior disclosure training was associated with increased willingness to disclose errors (odds ratio 1.40, p = 0.03).
Conclusions Trainees may not be prepared to disclose medical errors to patients and worrisome trends in trainee apology practices were observed across levels of training. Medical educators should intensify efforts to enhance trainees’ skills in meeting patients’ expectations for the open disclosure of harmful medical errors.</description><identifier>ISSN: 0308-0110</identifier><identifier>EISSN: 1365-2923</identifier><identifier>DOI: 10.1111/j.1365-2923.2010.03875.x</identifier><identifier>PMID: 21401685</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adult ; Attitude of Health Personnel ; Biological and medical sciences ; Clinical Competence ; Curriculum ; Education, Medical - methods ; Education, Medical - standards ; Health participants ; Humans ; Internship and Residency ; Male ; Medical Errors - ethics ; Medical Errors - psychology ; Medical sciences ; Miscellaneous ; Physician-Patient Relations ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Students, Medical - psychology ; Truth Disclosure - ethics ; Young Adult</subject><ispartof>Medical education, 2011-04, Vol.45 (4), p.372-380</ispartof><rights>Blackwell Publishing Ltd 2011</rights><rights>2015 INIST-CNRS</rights><rights>Blackwell Publishing Ltd 2011.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4935-35e7e15545cda5e65e6f41fc6e3f33c99e75a4719220f1bd9657fd28ed6fa2b33</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1365-2923.2010.03875.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1365-2923.2010.03875.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23948106$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21401685$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>White, Andrew A</creatorcontrib><creatorcontrib>Bell, Sigall K</creatorcontrib><creatorcontrib>Krauss, Melissa J</creatorcontrib><creatorcontrib>Garbutt, Jane</creatorcontrib><creatorcontrib>Dunagan, W Claiborne</creatorcontrib><creatorcontrib>Fraser, Victoria J</creatorcontrib><creatorcontrib>Levinson, Wendy</creatorcontrib><creatorcontrib>Larson, Eric B</creatorcontrib><creatorcontrib>Gallagher, Thomas H</creatorcontrib><title>How trainees would disclose medical errors: educational implications for training programmes</title><title>Medical education</title><addtitle>Med Educ</addtitle><description>Medical Education 2011: 45: 372–380
Objectives The disclosure of harmful errors to patients is recommended, but appears to be uncommon. Understanding how trainees disclose errors and how their practices evolve during training could help educators design programmes to address this gap. This study was conducted to determine how trainees would disclose medical errors.
Methods We surveyed 758 trainees (488 students and 270 residents) in internal medicine at two academic medical centres. Surveys depicted one of two harmful error scenarios that varied by how apparent the error would be to the patient. We measured attitudes and disclosure content using scripted responses.
Results Trainees reported their intent to disclose the error as ‘definitely’ (43%), ‘probably’ (47%), ‘only if asked by patient’ (9%), and ‘definitely not’ (1%). Trainees were more likely to disclose obvious errors than errors that patients were unlikely to recognise (55% versus 30%; p < 0.01). Respondents varied widely in the type of information they would disclose. Overall, 50% of trainees chose to use statements that explicitly stated that an error rather than only an adverse event had occurred. Regarding apologies, trainees were split between conveying a general expression of regret (52%) and making an explicit apology (46%). Respondents at higher levels of training were less likely to use explicit apologies (trend p < 0.01). Prior disclosure training was associated with increased willingness to disclose errors (odds ratio 1.40, p = 0.03).
Conclusions Trainees may not be prepared to disclose medical errors to patients and worrisome trends in trainee apology practices were observed across levels of training. Medical educators should intensify efforts to enhance trainees’ skills in meeting patients’ expectations for the open disclosure of harmful medical errors.</description><subject>Adult</subject><subject>Attitude of Health Personnel</subject><subject>Biological and medical sciences</subject><subject>Clinical Competence</subject><subject>Curriculum</subject><subject>Education, Medical - methods</subject><subject>Education, Medical - standards</subject><subject>Health participants</subject><subject>Humans</subject><subject>Internship and Residency</subject><subject>Male</subject><subject>Medical Errors - ethics</subject><subject>Medical Errors - psychology</subject><subject>Medical sciences</subject><subject>Miscellaneous</subject><subject>Physician-Patient Relations</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Students, Medical - psychology</subject><subject>Truth Disclosure - ethics</subject><subject>Young Adult</subject><issn>0308-0110</issn><issn>1365-2923</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkW9rFDEQxoMo9lr9CpI34qu9JptNNusLQc7-g6oILYIIIZednDmzm2ty612_fbO986ohkMzMw2-GeRDClExpPqfLKWWCF2VTsmlJcpYwWfPp9hmaHArP0YQwIgtCKTlCxyktCSE1r-RLdFTSilAh-QT9vAwbvI7a9QAJb8LgW9y6ZHxIgDtondEeQ4whpvcY2sHotQt9zrlu5d0uStiGuIO4foFXMSyi7jpIr9ALq32C1_v3BN2en93MLovrrxdXs4_XhakaxgvGoQbKecVNqzmIfG1FrRHALGOmaaDmuqppU5bE0nnbCF7btpTQCqvLOWMn6MOOuxrmeWYDfR7Gq1V0nY73Kmin_q_07pdahD-KcUI54xnwbg-I4W6AtFZd3gF4r3sIQ1JSsLomVNKsfPNvq0OPvxvNgrd7gU55dzbq3rj0pGNNJSkRTzNvnIf7Q50SNTqslmo0Uo1GqtFh9eiw2qrPZ59ux28GFDuAS2vYHgA6_laiZln7_cuFYrNvcnaTgx_sAY5zqyg</recordid><startdate>201104</startdate><enddate>201104</enddate><creator>White, Andrew A</creator><creator>Bell, Sigall K</creator><creator>Krauss, Melissa J</creator><creator>Garbutt, Jane</creator><creator>Dunagan, W Claiborne</creator><creator>Fraser, Victoria J</creator><creator>Levinson, Wendy</creator><creator>Larson, Eric B</creator><creator>Gallagher, Thomas H</creator><general>Blackwell Publishing Ltd</general><general>Wiley-Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201104</creationdate><title>How trainees would disclose medical errors: educational implications for training programmes</title><author>White, Andrew A ; Bell, Sigall K ; Krauss, Melissa J ; Garbutt, Jane ; Dunagan, W Claiborne ; Fraser, Victoria J ; Levinson, Wendy ; Larson, Eric B ; Gallagher, Thomas H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4935-35e7e15545cda5e65e6f41fc6e3f33c99e75a4719220f1bd9657fd28ed6fa2b33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Attitude of Health Personnel</topic><topic>Biological and medical sciences</topic><topic>Clinical Competence</topic><topic>Curriculum</topic><topic>Education, Medical - methods</topic><topic>Education, Medical - standards</topic><topic>Health participants</topic><topic>Humans</topic><topic>Internship and Residency</topic><topic>Male</topic><topic>Medical Errors - ethics</topic><topic>Medical Errors - psychology</topic><topic>Medical sciences</topic><topic>Miscellaneous</topic><topic>Physician-Patient Relations</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Students, Medical - psychology</topic><topic>Truth Disclosure - ethics</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>White, Andrew A</creatorcontrib><creatorcontrib>Bell, Sigall K</creatorcontrib><creatorcontrib>Krauss, Melissa J</creatorcontrib><creatorcontrib>Garbutt, Jane</creatorcontrib><creatorcontrib>Dunagan, W Claiborne</creatorcontrib><creatorcontrib>Fraser, Victoria J</creatorcontrib><creatorcontrib>Levinson, Wendy</creatorcontrib><creatorcontrib>Larson, Eric B</creatorcontrib><creatorcontrib>Gallagher, Thomas H</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medical education</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>White, Andrew A</au><au>Bell, Sigall K</au><au>Krauss, Melissa J</au><au>Garbutt, Jane</au><au>Dunagan, W Claiborne</au><au>Fraser, Victoria J</au><au>Levinson, Wendy</au><au>Larson, Eric B</au><au>Gallagher, Thomas H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>How trainees would disclose medical errors: educational implications for training programmes</atitle><jtitle>Medical education</jtitle><addtitle>Med Educ</addtitle><date>2011-04</date><risdate>2011</risdate><volume>45</volume><issue>4</issue><spage>372</spage><epage>380</epage><pages>372-380</pages><issn>0308-0110</issn><eissn>1365-2923</eissn><abstract>Medical Education 2011: 45: 372–380
Objectives The disclosure of harmful errors to patients is recommended, but appears to be uncommon. Understanding how trainees disclose errors and how their practices evolve during training could help educators design programmes to address this gap. This study was conducted to determine how trainees would disclose medical errors.
Methods We surveyed 758 trainees (488 students and 270 residents) in internal medicine at two academic medical centres. Surveys depicted one of two harmful error scenarios that varied by how apparent the error would be to the patient. We measured attitudes and disclosure content using scripted responses.
Results Trainees reported their intent to disclose the error as ‘definitely’ (43%), ‘probably’ (47%), ‘only if asked by patient’ (9%), and ‘definitely not’ (1%). Trainees were more likely to disclose obvious errors than errors that patients were unlikely to recognise (55% versus 30%; p < 0.01). Respondents varied widely in the type of information they would disclose. Overall, 50% of trainees chose to use statements that explicitly stated that an error rather than only an adverse event had occurred. Regarding apologies, trainees were split between conveying a general expression of regret (52%) and making an explicit apology (46%). Respondents at higher levels of training were less likely to use explicit apologies (trend p < 0.01). Prior disclosure training was associated with increased willingness to disclose errors (odds ratio 1.40, p = 0.03).
Conclusions Trainees may not be prepared to disclose medical errors to patients and worrisome trends in trainee apology practices were observed across levels of training. Medical educators should intensify efforts to enhance trainees’ skills in meeting patients’ expectations for the open disclosure of harmful medical errors.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>21401685</pmid><doi>10.1111/j.1365-2923.2010.03875.x</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Wiley Journals; EBSCOhost Education Source |
| subjects | Adult Attitude of Health Personnel Biological and medical sciences Clinical Competence Curriculum Education, Medical - methods Education, Medical - standards Health participants Humans Internship and Residency Male Medical Errors - ethics Medical Errors - psychology Medical sciences Miscellaneous Physician-Patient Relations Public health. Hygiene Public health. Hygiene-occupational medicine Students, Medical - psychology Truth Disclosure - ethics Young Adult |
| title | How trainees would disclose medical errors: educational implications for training programmes |
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