Do faculty and resident physicians discuss their medical errors?
- 1Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, lowa, USA
- 2Program in Biomedical Ethics and Medical Humanities, University of Iowa Carver College of Medicine, Iowa City, lowa, USA
- 3Center for Research in the Implementation of Innovative Strategies in Practice, Iowa City VA Medical Center, Iowa City, lowa, USA
- 4Department of Internal Medicine, Hospital of St. Raphael, New Haven, Connecticut, USA
- 5Yale University School of Medicine, New Haven, connecticut, USA
- 6Departments of Humanities and Pediatrics, Penn State College of Medicine and Hershey Medical Center, Hershey, Pennsylvania, USA
- 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;
- Received 13 November 2007
- Revised 1 February 2008
- Accepted 7 February 2008
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.
Competing interests: None.
Funding: This study was funded by the Robert Wood Johnson Foundation’s Generalist Physician Faculty Scholars Program, through a grant to LK (grant # 45446). The funding organisation had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; or preparation, review or approval of the manuscript.
LCK had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
LCK, VLF-H and GER are investigators in the Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP) at the VA Iowa City VA Health Care System, which is funded through the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.
Ethics approval: Approval was given by the Institutional Review Boards at each of the participating institutions.