Medical students' experiences with medical errors: an analysis of medical student essays

Abstract

There are many missed opportunities to teach students how to respond to and learn from errors. Some faculty members and housestaff may at times respond to errors in ways that appear to contradict professional standards. Medical educators should increase exposure to exemplary responses to errors and help students to learn from and cope with errors.

Coping with medical error: a systematic review of papers to assess the effects of involvement in medical errors on healthcare professionals' psychological well-being

“…Nursing samples were also consistent in raising a feeling of personal responsibility for an error and the commitment to reporting such incidents regardless of an increased likelihood of being blamed 14 24 26 30. Papers featuring trainee samples highlighted the learning element of making an error, focussing on clinical outcomes and change in practice 16 19 31 34. All studies that explored only adverse events, or the most memorable or significant error, included samples limited to physicians, resulting in increased focus on the activities taken to manage the clinical outcomes of the error and professional repercussions of these events 15 22 29 32 35.…”

“…Individuals may function at the expected performance level but continue to be disturbed by the error event, where others may experience enhanced performance as a result of actively engaging in improving practice after a negative clinical incident 17. The importance of handling error in the correct way with a trainee sample was also highlighted, that is, avoiding punitive action or negative responses 21 31. Wolf et al suggested that the inadequate management of error resulted in less learning, and poorer coping going forward 27…”

“…Several papers therefore explicitly studied the socialisation of those in medical training 9. It was suggested that the ideology of internal accountability and infallibility resulted in profound self-doubt and guilt in medical trainees 18 31. Similarly, other key factors that influenced attitudes towards error were highlighted in qualitative work and included the hierarchical influence within the workplace, the threat of litigation and experiences of error.…”

“…Similarly, other key factors that influenced attitudes towards error were highlighted in qualitative work and included the hierarchical influence within the workplace, the threat of litigation and experiences of error. Lower-grade workers experienced disapproving responses to error disclosures by managers and were discouraged from disclosing errors by senior colleagues 27 31. Such negative attitudes appeared to be linked to the fear of litigation and professional loyalty.…”

Professional Integrity and the Role of Medical Students in Professional Self-Regulation

“…Students should be helped to learn from and cope with medical errors [42] and should see in real time how teams and leaders take accountability for medical errors and full disclosure. Teaching has been shown to improve learners' knowledge, skills, and attitudes to error disclosure [43].…”