Disclosing Medical Errors and Coping With the Emotions That Follow
Dowers C. Disclosing Medical Errors and Coping With the Emotions That Follow. Ann Emerg Med 2019; 74(4):S156.
Ann Emerg Med
Introduction: It is estimated that every year in American, greater than 250,000 deaths are due to medical errors. While our system continues to work to reduce this number, disclosing these errors is an essential component of patient care and physician well-being. Many beginning residents have never had formal training in disclosing errors, and very few of them have ever had instruction on coping with the emotions they will experience after dealing with a negative patient outcome. The goal of this lecture and simulation is to describe to new residents how to disclose medical errors and prepare them to thrive after making an error. Objectives: After attending this session, the learner will be able to demonstrate how to disclose a medical error. They will be able to recall the main components of this type of discussion and use this skill in a simulated setting. Residents will be prepared to recognize and cope with the emotions that they might feel after erring or experiencing a poor patient outcome secondary to their care. They will be able to describe second victim syndrome and recall the stages of the recovery process as described by Scott et al. Methods: During this session, the learner will attend a 45-minute lecture that informs them of the importance of disclosure and describe acceptable ways to disclose medical errors. This will be followed by a 15-minute demonstration by a staff physician and a simulated patient. After the demonstration, each resident will have a 15-minute simulation where they will disclose a medical error to a simulated patient. The simulated patient will score the resident on how they demonstrated empathy and included the essential elements of a disclosure discussion. After the simulation session, residents will return for a 45-minute lecture on coping with the emotions and process of recovery which many physicians face after making a medical error or treating a patient with a poor outcome. This will include defining the second victim syndrome and discussing the recovery process. Knowledge of this content will be evaluated with a multiple-choice questionnaire. Effectiveness of the program will be assessed at the end of each year with a survey to the residents to evaluate how they used the tools learned from this program. Also, we will encourage residents to self-report when an error has been made and report how the simulation did or did not apply to the situation so that we can continue to improve our presentation. Conclusion: After completing this two-hour session, residents will be able to accurately deliver information to patients and their families about medical errors. They will also be prepared to cope with the emotions which come after committing a medical error or having a bad patient outcome.