Teaching medical error disclosure to residents using patient-centered simulation training.
Document Type
Article
Publication Title
Academic medicine : journal of the Association of American Medical Colleges
Abstract
Purpose: To determine whether a standardized patient encounter and self-guided tutorial would improve first-year residents' self-efficacy for disclosing medical errors.
Method: In 2011, 55 first-year residents participated in a simulation in which they disclosed an error to a standardized patient playing the part of a family member. Residents completed the simulation twice, four weeks apart, and completed presession knowledge and self-efficacy (based on the Accreditation Council for Graduate Medical Education [ACGME] core competencies) assessments and repeated the self-efficacy assessment after the sessions. Residents reviewed the videos of their encounters either alone (self-debrief) or with a faculty observer (faculty debrief). Between sessions, they completed a self-paced learning tutorial. Two external faculty also rated the residents' performances using videos of the encounters.
Results: Residents' self-efficacy significantly increased from a Session 1 pretest mean (standard deviation) score of 119.6 (26.6) to a Session 2 posttest score of 150.3 (24.9) for all ACGME competencies (P < .001, Cohen's d = 1.19). The external reviewers' ratings provided additional, objective support for residents' improvement on questions assessing ACGME competencies (P = .001). Comparisons of the self-efficacy of residents in the self-debrief versus faculty debrief groups yielded no significant differences on any ACGME competencies.
Conclusions: Timely, explicit, and empathetic disclosure of medical errors to patients and family is essential to maintaining trust and is an important part of patient-centered medical care. This intervention easily could be replicated in other settings and is applicable to many members of the health care team, not just to residents.
First Page
136
Last Page
143
DOI
10.1097/ACM.0000000000000046
Publication Date
1-1-2014
Recommended Citation
Sukalich S, Elliott JO, Ruffner G. Teaching medical error disclosure to residents using patient-centered simulation training. Acad Med. 2014 Jan;89(1):136-43. doi: 10.1097/ACM.0000000000000046. PMID: 24280843.