| Improving the patient, family, and clinician experience after harmful events: the "when things go wrong" curriculum. | |
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MedLine Citation:
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PMID: 20505403 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The emotional toll of medical error is high for both patients and clinicians, who are often unsure with whom-and whether-they can discuss what happened. Although institutions are increasingly adopting full disclosure policies, trainees frequently do not disclose mistakes, and faculty physicians are underprepared to teach communication skills related to disclosure and apology. The authors developed an interactive educational program for trainees and faculty physicians that assesses experiences, attitudes, and perceptions about error, explores the human impact of error through filmed patient and family narratives, develops communication skills, and offers a strategy to facilitate bedside disclosures. Between spring 2007 and fall 2008, 154 trainees (medical students/residents) and 75 medical educators completed the program. Among learners surveyed, 62% of trainees and 88% of faculty physicians reported making medical mistakes. Of those, 62% and 78%, respectively, reported they did not apologize. While 65% of trainees said they would turn to senior doctors for assistance after an error, 26% were not sure where to get help. Just 20% of trainees and 21% of physicians reported adequate training to respond to error. Following the session, all of the faculty physicians surveyed indicated they felt better prepared to address and teach this topic. At a time of increased attention to disclosure, actual faculty and trainee practices suggest that role models, support systems, and education strategies are lacking. Trainees' widespread experience with error highlights the need for a disclosure curriculum early in medical education. Educational initiatives focusing on communication after harm should target teachers and students. |
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Authors:
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Sigall K Bell; Donald W Moorman; Tom Delbanco |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Academic medicine : journal of the Association of American Medical Colleges Volume: 85 ISSN: 1938-808X ISO Abbreviation: Acad Med Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-06-03 Completed Date: 2010-06-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8904605 Medline TA: Acad Med Country: United States |
Other Details:
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Languages: eng Pagination: 1010-7 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. sbell1@bidmc.harvard.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Communication Curriculum Education, Medical / methods* Faculty, Medical Family / psychology* Humans Medical Errors / psychology* Patients / psychology* Physicians / psychology* Truth Disclosure |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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