Do faculty and resident physicians discuss their medical errors?

Kaldjian, Lauris C.; Forman‐Hoffman, Valerie L.; Jones, Elizabeth W.; Wu, Barry J.; Levi, Benjamin H.; Rosenthal, Gary E.

doi:10.1136/jme.2007.023713

Cited by 54 publications

(40 citation statements)

References 38 publications

(44 reference statements)

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“…Clinicians who discuss the clinical error with colleagues do this usually for professional and personal reasons including the need for emotional support (Kaldjian et al, 2008).…”

Section: Resultsmentioning

confidence: 99%

Supporting involved health care professionals (second victims) following an adverse health event: A literature review

Seys

Scott

et al. 2013

International Journal of Nursing Studies

186

192

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“…Clinicians who discuss the clinical error with colleagues do this usually for professional and personal reasons including the need for emotional support (Kaldjian et al, 2008).…”

Section: Resultsmentioning

confidence: 99%

Supporting involved health care professionals (second victims) following an adverse health event: A literature review

Seys

Scott

et al. 2013

International Journal of Nursing Studies

186

192

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“…[2][3][4] Much work has been done studying the effect of incidents on patients, 5,6 but examining the effect on caregivers, also referred to as "the second victim," [2][3][4] is in its infancy. Previous studies have focused on the acute care system and medical residents [7][8][9][10][11][12][13][14][15][16] or a compilation of acute and primary care. [17][18][19][20] Only 2 studies have explored the emotional impact of incidents on primary care providers alone.…”

mentioning

confidence: 99%

Emotional Impact of Patient Safety Incidents on Family Physicians and Their Office Staff

O’Beirne¹,

Sterling²,

Palacios-Derflingher³

et al. 2012

The Journal of the American Board of Family Medicine

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Objective: The objective of this study was to investigate the emotional responses and coping strategies that family physicians and their office staff reported in response to a patient safety incident.Method: Two questions contained in a patient safety incident report developed for a study of patient safety in family practice were analyzed. The questions asked reporters to indicate their emotional response to a patient safety incident and how they coped with it. A total of 264 confidential patient safety incident reports collected from September 2007 to August 2010 were analyzed.Results: An emotional response was reported on 82.4% of reports. Of those reports on which an emotional response was reported, a coping strategy was reported on 62.8%. The top 4 reported emotional responses were frustration (48.3%), embarrassment (31.5%), anger (12.6%), and guilt (10.1%). Physicians reported an emotional response more often than clinic staff. An emotional response was reported more often when there was a possibility of harm. Coping strategies were reported as follows: 52% talked to someone about the incident, 37.2% did nothing in response to the incident, 17.9% told the patient about the incident, and 3.6% did something else. Female physicians reported using coping strategies less often than male physicians. A coping strategy was reported more often when there was a possibility of harm. Conclusions: All members of the health care team report experiencing emotions related to patient safety incidents in their practice. Incidents with minor or no harm still invoked emotional responses from the providers. It is important to understand the impact that patient safety incidents have on the medical clinic as a whole. (J Am Board Fam Med 2012;25:177-183.) Keywords: Coping Skills, Family Medicine Research, Medical Errors, Patient SafetyA patient safety incident is an event or process that could have resulted or did result in unnecessary harm to a patient.1 Patient safety incidents affect both the patient and caregivers.2-4 Much work has been done studying the effect of incidents on patients, 5,6 but examining the effect on caregivers, also referred to as "the second victim," 2-4 is in its infancy. Previous studies have focused on the acute care system and medical residents [7][8][9][10][11][12][13][14][15][16] or a compilation of acute and primary care. [17][18][19][20] Only 2 studies have explored the emotional impact of incidents on primary care providers alone. 21,22 The first explored the emotional impact of the most memorable mistake on the family physician and his or her response to a hypothetical scenario. 21 The second used focus groups of family physicians and residents to develop a reference statement for the appropriate management of mistakes in the training environment. 22Other research, primarily in acute care, found that health professionals have varied emotional responses to incidents.

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“…Similar to a medical study [39], the PTs argued in favour of the discussion of errors with colleagues, especially targeted at collegial support. In medicine, studies found that this approach enables peer learning by seeing each other as role models [39]. A similar range of considerations was found in our study.…”

Section: Discussionmentioning

confidence: 93%

“…The frequent reference to a character of integrity may reflect the significance of virtue ethics [39-41] for individual orientation as a psychotherapist. It suggests that human qualities play an important role for the profession and personal virtues of (famous) psychotherapists might offer a general ethical orientation.…”

Section: Discussionmentioning

confidence: 99%

How psychotherapists handle treatment errors – an ethical analysis

Medau

Jox²,

Reiter-Theil

2013

BMC Med Ethics

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BackgroundDealing with errors in psychotherapy is challenging, both ethically and practically. There is almost no empirical research on this topic. We aimed (1) to explore psychotherapists’ self-reported ways of dealing with an error made by themselves or by colleagues, and (2) to reconstruct their reasoning according to the two principle-based ethical approaches that are dominant in the ethics discourse of psychotherapy, Beauchamp & Childress (B&C) and Lindsay et al. (L).MethodsWe conducted 30 semi-structured interviews with 30 psychotherapists (physicians and non-physicians) and analysed the transcripts using qualitative content analysis. Answers were deductively categorized according to the two principle-based ethical approaches.ResultsMost psychotherapists reported that they preferred to an disclose error to the patient. They justified this by spontaneous intuitions and common values in psychotherapy, rarely using explicit ethical reasoning. The answers were attributed to the following categories with descending frequency: 1. Respect for patient autonomy (B&C; L), 2. Non-maleficence (B&C) and Responsibility (L), 3. Integrity (L), 4. Competence (L) and Beneficence (B&C).ConclusionsPsychotherapists need specific ethical and communication training to complement and articulate their moral intuitions as a support when disclosing their errors to the patients. Principle-based ethical approaches seem to be useful for clarifying the reasons for disclosure. Further research should help to identify the most effective and acceptable ways of error disclosure in psychotherapy.

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Do faculty and resident physicians discuss their medical errors?

Cited by 54 publications

References 38 publications

Supporting involved health care professionals (second victims) following an adverse health event: A literature review

Supporting involved health care professionals (second victims) following an adverse health event: A literature review

Emotional Impact of Patient Safety Incidents on Family Physicians and Their Office Staff

How psychotherapists handle treatment errors – an ethical analysis

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