Clinical Dental Faculty Members’ Perceptions of Diagnostic Errors and How to Avoid Them

Abstract

Diagnostic errors are increasingly recognized as a source of preventable harm in medicine, yet little is known about their occurrence in dentistry. The aim of this study was to gain a deeper understanding of clinical dental faculty members' perceptions of diagnostic errors, types of errors that may occur, and possible contributing factors. The authors conducted semi-structured interviews with ten domain experts at one U.S. dental school in May-August 2016 about their perceptions of diagnostic errors and their causes. The interviews were analyzed using an inductive process to identify themes and key findings. The results showed that the participants varied in their definitions of diagnostic errors. While all identified missed diagnosis and wrong diagnosis, only four participants perceived that a delay in diagnosis was a diagnostic error. Some participants perceived that an error occurs only when the choice of treatment leads to harm. Contributing factors associated with diagnostic errors included the knowledge and skills of the dentist, not taking adequate time, lack of communication among colleagues, and cognitive biases such as premature closure based on previous experience. Strategies suggested by the participants to prevent these errors were taking adequate time when investigating a case, forming study groups, increasing communication, and putting more emphasis on differential diagnosis. These interviews revealed differing perceptions of dental diagnostic errors among clinical dental faculty members. To address the variations, the authors recommend adopting shared language developed by the medical profession to increase understanding.

Diagnostic errors in Dentistry, opinions of egyptian dental teaching staff, a cross-sectional study

“…Further, this finding is supported by previous studies where delays in referral by clinicians are a huge contributing factor to delayed diagnosis of oral cancer [ 20 , 28 , 29 ]. Oral cancer and periodontal diseases were also on the top of the missed and delayed diagnosed dental conditions reported by Nikdel et al [ 7 ]. Regression analysis showed that Al-Azhar and Governmental universities staff reported that oral mucosal lesions were the most diagnostic errors conditions followed by pulp therapy related conditions, disagreeing with the staff of Private universities who reported the pulp therapy related conditions to be the most common diagnostic errors conditions, more data regarding various aspects related to teaching and assessment methods and the contents of both subjects is needed to explain this observation.…”

“…Two of our study participants were teaching staff at the bio-dental materials department, which is an academic department, however, they do have a private clinic. General dentists were excluded in accordance with Nikdel et al, 2018 as dentists in dental centers or private offices who experience an error-in the best of cases, they learn from it, but in most cases, they will try to conceal it from other professionals [ 7 ]. This means that a bulk of information on errors will be lost and cannot be properly studied.…”

“…The third part of our survey addressed the contributing factors that might cause dental diagnostic errors, in addition to the known system-related and cognitive-related factors, Nikdel et al added patient-related factors [ 7 ]. In our questionnaire, we didn’t include a direct choice regarding patient-related factors, as we believe that understanding the patient complaint correctly and proper communication with the patient is a skill and cognitive ability of the dentist, further, and in support of this belief, none of our participants pointed out to patient-related factors in other possible causes of diagnostic errors.…”

“…The questionnaire was designed by the authors to cover the study objectives, guided by previously published relevant studies [ 3 , 7 ]. Afterward, an independent committee including experts in community medicine, oral medicine, biostatistics, oral public health, epidemiology, and healthcare quality reviewed the questionnaire draft to assess the face and content validity.…”

“…Despite numerous efforts and initiatives aiming to promote patients’ safety by reducing the occurrence of diagnostic errors, in dentistry, many patients suffer harm in dental clinics [ 7 , 8 ]. Previous reports showed that there is an increase in dental complaints and negligence claims and 9% of these claims are related to diagnostic errors [ 9 ].…”