Title

Learning from mistakes. Factors that influence how students and residents learn from medical errors

UMMS Affiliation

Office of Medical Education; Department of Family Medicine and Community Health; Meyers Primary Care Institute; Department of Medicine; Graduate Medical Education

Date

5-18-2006

Document Type

Article

Subjects

Attitude of Health Personnel; Curriculum; Education, Medical, Undergraduate; Emotions; Humans; Internal Medicine; *Internship and Residency; *Learning; Medical Errors; Students, Medical; Surgery; Teaching

Disciplines

Life Sciences | Medical Education | Medicine and Health Sciences

Abstract

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.

Rights and Permissions

Citation: J Gen Intern Med. 2006 May;21(5):419-23. Link to article on publisher's site

Related Resources

Link to article in PubMed

PubMed ID

16704381