Clinical ethics

Do faculty and resident physicians discuss their medical errors?

¹ Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, lowa, USA
² Program in Biomedical Ethics and Medical Humanities, University of Iowa Carver College of Medicine, Iowa City, lowa, USA
³ Center for Research in the Implementation of Innovative Strategies in Practice, Iowa City VA Medical Center, Iowa City, lowa, USA
⁴ Department of Internal Medicine, Hospital of St. Raphael, New Haven, Connecticut, USA
⁵ Yale University School of Medicine, New Haven, connecticut, USA
⁶ Departments of Humanities and Pediatrics, Penn State College of Medicine and Hershey Medical Center, Hershey, Pennsylvania, USA

Correspondence to:
Dr L C Kaldjian, Department of Internal Medicine, 1-106 MEB, University of Iowa Carver College of Medicine, 500 Newton Road, Iowa City, IA 52242; lauris-kaldjian{at}uiowa.edu

Background: Discussions about medical errors facilitate professional learning for physicians and may provide emotional support after an error, but little is known about physicians’ attitudes and practices regarding error discussions with colleagues.

Methods: Survey of faculty and resident physicians in generalist specialties in Midwest, Mid-Atlantic and Northeast regions of the US to investigate attitudes and practices regarding error discussions, likelihood of discussing hypothetical errors, experience role-modelling error discussions and demographic variables.

Results: Responses were received from 338 participants (response rate = 74%). In all, 73% of respondents indicated they usually discuss their mistakes with colleagues, 70% believed discussing mistakes strengthens professional relationships and 89% knew at least one colleague who would be a supportive listener. Motivations for error discussions included wanting to learn whether a colleague would have made the same decision (91%), wanting colleagues to learn from the mistake (80%) and wanting to receive support (79%). Given hypothetical scenarios, most respondents indicated they would likely discuss an error resulting in no harm (77%), minor harm (87%) or major harm (94%). Fifty-seven percent of physicians had tried to serve as a role model by discussing an error and role-modelling was more likely among those who had previously observed an error discussion (OR 4.17, CI 2.34 to 7.42).

Conclusions: Most generalist physicians in teaching hospitals report that they usually discuss their errors with colleagues, and more than half have tried to role-model discussions. However, a significant number of these physicians report that they do not usually discuss their errors and some do not know colleagues who would be supportive listeners.

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