Do House Officers Learn From Their Mistakes?
Wu, Albert W.
McPhee, Stephen J.
JAMA. 1991 Apr 24; 265(16): 2089-2094.
Mistakes are inevitable in medicine. To learn how medical mistakes relate to subsequent changes in practice, we surveyed 254 internal medicine house officers. One hundred fourteen house officers (45%) completed an anonymous questionnaire describing their most significant mistake and their response to it. Mistakes included errors in diagnosis (33%), prescribing (29%), evaluation (21%), and communication (5%), and procedural complications (11%). Patients had serious adverse outcomes in 90% of the cases, including death in 31% of cases. Only 54% of house officers discussed the mistake with their attending physicians, and only 24% told the patients or families. House officers who accepted responsibility for the mistake and discussed it were more likely to report constructive changes in practice. Residents were less likely to make constructive changes if they attributed the mistake to job overload. They were more likely to report defensive changes....
Attitudes; Communication; Competence; Death; Diagnosis; Disclosure; Disease; Drugs; Education; Evaluation; Hospitals; Iatrogenic Disease; Institutional Policies; Internal Medicine; Medical Education; Medical Errors; Medicine; Patient Care; Patients; Physicians; Professional Competence; Psychological Stress; Residency; Survey; Truth Disclosure;
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Do House Officers Learn From Their Mistakes? Wu, Albert W.; Folkman, Susan; McPhee, Stephen J. and Lo, Bernard (1991-04-24)