The influence of the causes and contexts of medical errors on emergency medicine residents' responses to their errors: An exploration

Cherri Hobgood, Armando Hevia, Joshua H. Tamayo-Sarver, Bryan Weiner, Ralph Riviello

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Purpose To determine emergency medicine residents' emotional and behavioral responses to their medical errors and examine associations between residents' responses to medical error and perceptions of their training. Method In 2003, 55 residents at two U.S. residency programs were asked to complete questionnaires about their errors and responses to their errors in three domains: emotional response, learning behavior, and disclosure. The questions were a mixture of free text, yes/no responses, and some were rated using a five-point Likert scale. Based on a conceptual framework, the authors constructed scales to describe the various domains and associations between the residents' responses to medical error and perceptions of their training were examined using Somers' D. Results A total of 43 residents returned questionnaires (80%); 40 of these residents described errors. Thirty-three (83%) residents discussed the error with someone; 27 (71%) with the attending and 10 (28%) with the patient/family. Negative emotions were common: 27 (68%) felt remorse, 21 (53%) guilt, 23 (58%) inadequacy, and 22 (55%) frustration. Residents' negative emotional responses were associated with their personal characteristics [26% (95% CI, 5-47%) association with lack of experience] and residents' perceptions of their training environment: 15% association with job overload (95% CI, -8-38%) and 23% association with lack of institutional support (95% CI, 5-41%). While 32 (81%) residents increased attention to detail, only 2 (5%) increased their use of evidence-based medicine. Conclusions Errors committed by emergency medicine residents often resulted in negative emotions, limited constructive system-based improvements, and inadequate disclosure. Negative perceptions of the training environment are associated with negative emotional responses.

Original languageEnglish (US)
Pages (from-to)758-764
Number of pages7
JournalAcademic Medicine
Volume80
Issue number8
DOIs
StatePublished - Aug 2005
Externally publishedYes

Fingerprint

Medical Errors
Emergency Medicine
Disclosure
medicine
resident
cause
Emotions
Frustration
Guilt
Evidence-Based Medicine
Internship and Residency
Learning
emotion
learning behavior
questionnaire
lack
Surveys and Questionnaires
guilt
frustration

ASJC Scopus subject areas

  • Nursing(all)
  • Public Health, Environmental and Occupational Health
  • Education

Cite this

The influence of the causes and contexts of medical errors on emergency medicine residents' responses to their errors : An exploration. / Hobgood, Cherri; Hevia, Armando; Tamayo-Sarver, Joshua H.; Weiner, Bryan; Riviello, Ralph.

In: Academic Medicine, Vol. 80, No. 8, 08.2005, p. 758-764.

Research output: Contribution to journalArticle

Hobgood, Cherri ; Hevia, Armando ; Tamayo-Sarver, Joshua H. ; Weiner, Bryan ; Riviello, Ralph. / The influence of the causes and contexts of medical errors on emergency medicine residents' responses to their errors : An exploration. In: Academic Medicine. 2005 ; Vol. 80, No. 8. pp. 758-764.
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abstract = "Purpose To determine emergency medicine residents' emotional and behavioral responses to their medical errors and examine associations between residents' responses to medical error and perceptions of their training. Method In 2003, 55 residents at two U.S. residency programs were asked to complete questionnaires about their errors and responses to their errors in three domains: emotional response, learning behavior, and disclosure. The questions were a mixture of free text, yes/no responses, and some were rated using a five-point Likert scale. Based on a conceptual framework, the authors constructed scales to describe the various domains and associations between the residents' responses to medical error and perceptions of their training were examined using Somers' D. Results A total of 43 residents returned questionnaires (80{\%}); 40 of these residents described errors. Thirty-three (83{\%}) residents discussed the error with someone; 27 (71{\%}) with the attending and 10 (28{\%}) with the patient/family. Negative emotions were common: 27 (68{\%}) felt remorse, 21 (53{\%}) guilt, 23 (58{\%}) inadequacy, and 22 (55{\%}) frustration. Residents' negative emotional responses were associated with their personal characteristics [26{\%} (95{\%} CI, 5-47{\%}) association with lack of experience] and residents' perceptions of their training environment: 15{\%} association with job overload (95{\%} CI, -8-38{\%}) and 23{\%} association with lack of institutional support (95{\%} CI, 5-41{\%}). While 32 (81{\%}) residents increased attention to detail, only 2 (5{\%}) increased their use of evidence-based medicine. Conclusions Errors committed by emergency medicine residents often resulted in negative emotions, limited constructive system-based improvements, and inadequate disclosure. Negative perceptions of the training environment are associated with negative emotional responses.",
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