Residents?? Responses to Medical Error: Coping, Learning, and Change

Abstract

Medical mishaps have a profound impact on resident physicians by eliciting intense emotional responses. It is critical that resident training programs recognize the personal and professional significance of these experiences for young physicians. Moreover, resident education must support the development of constructive coping skills by facilitating candid discussion and learning subsequent to these events.

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

“…Supervisors can support second victims by emphasizing their continued trust in them. This can be done by reassuring the second victim that their professional abilities are still important to the organization and to their professional teams (Engel et al, 2006;Newman, 1996;Schwappach and Boluarte, 2008). Scott et al (2008) suggest that immediate support should be provided to the clinician following the adverse event and that the time between the adverse event and support is crucial.…”

“…In designing a support network, organizations should also consider that students also can become second victims and should be included in support programs. Engel et al (2006) suggest that residency programs should provide educational opportunities to openly discuss errors even if they are associated with good patient outcomes and little perceived resident physicians" responsibility. They encourage development of widespread "error conferences" like death and complication and morbidity and mortality conferences.…”

“…Death and complication as well as morbidity and mortality conferences are valuable opportunities to review adverse events and medical errors (Engel et al, 2006;Gallagher et al, 2003;Hobgood et al, 2005). These types of conferences were found to be helpful for surgical and obstetrical resident physicians to share their experience and identify ways to do things differently in the future.…”

“…These types of conferences were found to be helpful for surgical and obstetrical resident physicians to share their experience and identify ways to do things differently in the future. These conferences can be structured sessions or facilitate and encourage more informal open discussions which may generate powerful synergy among the health care team and can be modified to allow open discussion of the physician"s emotional reaction to the adverse event (Engel et al, 2006;Levinson and Dunn, 1989;Smith and Forster, 2000). Some programs include a reflective writing intervention as described by Janel Sexton et al (2009).…”

“…Health care institutions often fail to take responsibility for the provision of support and provision of the necessary elements of a support system (Conway et al, 2010;Gallagher et al, 2003;Schwappach and Boluarte, 2009). In some cases, second victims are only able to find solace outside of their institutions, during national or international conferences (Engel et al, 2006;Gallagher et al, 2003;van Pelt, 2008).…”