Learning from mistakes. Factors that influence how students and residents learn from medical errors
Authors
Fischer, Melissa A.Mazor, Kathleen M.
Baril, Joann L.
Alper, Eric J.
DeMarco, Deborah M.
Pugnaire, Michele P.
UMass Chan Affiliations
Graduate Medical EducationDepartment of Medicine
Meyers Primary Care Institute
Department of Family Medicine and Community Health
Office of Medical Education
Document Type
Journal ArticlePublication Date
2006-05-18Keywords
Attitude of Health PersonnelCurriculum
Education, Medical, Undergraduate
Emotions
Humans
Internal Medicine
*Internship and Residency
*Learning
Medical Errors
Students, Medical
Surgery
Teaching
Life Sciences
Medical Education
Medicine and Health Sciences
Metadata
Show full item recordAbstract
CONTEXT: Trainees are exposed to medical errors throughout medical school and residency. Little is known about what facilitates and limits learning from these experiences. OBJECTIVE: To identify major factors and areas of tension in trainees' learning from medical errors. DESIGN, SETTING, AND PARTICIPANTS: Structured telephone interviews with 59 trainees (medical students and residents) from 1 academic medical center. Five authors reviewed transcripts of audiotaped interviews using content analysis. RESULTS: Trainees were aware that medical errors occur from early in medical school. Many had an intense emotional response to the idea of committing errors in patient care. Students and residents noted variation and conflict in institutional recommendations and individual actions. Many expressed role confusion regarding whether and how to initiate discussion after errors occurred. Some noted the conflict between reporting errors to seniors who were responsible for their evaluation. Learners requested more open discussion of actual errors and faculty disclosure. No students or residents felt that they learned better from near misses than from actual errors, and many believed that they learned the most when harm was caused. CONCLUSIONS: Trainees are aware of medical errors, but remaining tensions may limit learning. Institutions can immediately address variability in faculty response and local culture by disseminating clear, accessible algorithms to guide behavior when errors occur. Educators should develop longitudinal curricula that integrate actual cases and faculty disclosure. Future multi-institutional work should focus on identified themes such as teaching and learning in emotionally charged situations, learning from errors and near misses and balance between individual and systems responsibility.Source
J Gen Intern Med. 2006 May;21(5):419-23. Link to article on publisher's site
DOI
10.1111/j.1525-1497.2006.00420.xPermanent Link to this Item
http://hdl.handle.net/20.500.14038/50746PubMed ID
16704381Related Resources
ae974a485f413a2113503eed53cd6c53
10.1111/j.1525-1497.2006.00420.x
Scopus Count
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