Pediatric residents' decision-making around disclosing and reporting adverse events: the importance of social context.
Acad Med
; 85(10): 1619-25, 2010 Oct.
Article
en En
| MEDLINE
| ID: mdl-20881681
PURPOSE: Although experts advise disclosing medical errors to patients, individual physicians' different levels of knowledge and comfort suggest a gap between recommendations and practice. This study explored pediatric residents' knowledge and attitudes about disclosure. METHOD: In 2006, the authors of this single-center, mixed-methods study surveyed 64 pediatric residents at the University of Toronto and then held three focus groups with a total of 24 of those residents. RESULTS: Thirty-seven (58%) residents completed questionnaires. Most agreed that medical errors are one of the most serious problems in health care, that errors should be disclosed, and that disclosure would be difficult. When shown a scenario involving a medical error, over 90% correctly identified the error, but only 40% would definitely disclose it. Most would apologize, but far fewer would acknowledge harm if it occurred or use the word "mistake." Most had witnessed or performed a disclosure, but only 40% reported receiving teaching on disclosure. Most reported experiencing negative effects of errors, including anxiety and reduced confidence. Data from the focus groups emphasized the extent to which residents consider contextual information when making decisions around disclosure. Themes included their or their team's degree of responsibility for the error versus others, quality of team relationships, training level, existence of social boundaries, and their position within a hierarchy. CONCLUSIONS: These findings add to the understanding of facilitators and inhibitors of error disclosure and reporting. The influence of social context warrants further study and should be considered in medical curriculum design and hospital guideline implementation.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Pediatría
/
Medio Social
/
Revelación de la Verdad
/
Conocimientos, Actitudes y Práctica en Salud
/
Errores Médicos
/
Toma de Decisiones
/
Internado y Residencia
Tipo de estudio:
Guideline
/
Prognostic_studies
/
Qualitative_research
Aspecto:
Determinantes_sociais_saude
Límite:
Adult
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Acad Med
Asunto de la revista:
EDUCACAO
Año:
2010
Tipo del documento:
Article
País de afiliación:
Canadá
Pais de publicación:
Estados Unidos