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05-01-2012 | Legal medicine | Article

GP trainees need more open-minded discussion of medical errors


Free abstract

MedWire News: Medical errors are a sensitive topic for general practitioners (GPs) in training and more open discussion is required to prevent future errors, show interviews with French interns.

Researchers from Paris Diderot University, led by Eric Galam, asked GP interns to complete an online anonymous questionnaire and recorded a series of semi-structured interviews with 10 volunteer interns. They received 70 responses from the 392 who were sent questionnaires, 97% of whom had already made a medical error. The minimum possible estimate of self-reported medical error prevalence from this sample is 17%.

The team found that 64% of interns were at least strongly affected by their error and 74% made changes to their work after the incident. A third of the respondents thought their error had severe consequences for the patient. Only 57% of the interns disclosed their error to their professional supervisor.

"Healthcare workers are often impacted by medical errors as 'second victims', and experience many of the same emotions and/or feelings that the 'first victims' - the patient and family members [felt]," write Albert Wu (John Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA) and Rachel Steckelberg (Mayo Medical School, Rochester, Minnesota, USA), authors of an editorial on the research.

"Signs and symptoms are similar to those in acute distress disorder… added symptoms related to medical errors include shame, guilt, anger, and self-doubt."

Five of the interviewees replayed their mistake for a long time after the event, say the researchers; for example, one said that "every time I saw someone, I had to speak about what had happened… I replay the scene to see what I could have done differently."

According to Galam and his team, most of the interns said that dealing with their error would have been easier if their hospital department had provided more opportunities for group discussion. Another major factor, they say, was the negative reaction received from more senior staff, often without an attempt to analyze the situation.

"This study helped us to show that there are several gaps in our training as future GPs that could be easily filled… the creation of forums for group discussion around mistakes, to help each other understand that we are never alone and to help prevent the same mistake happening twice," write Galam et al.

The research and its accompanying editorial are published in the journal BMJ Quality and Safety.

By Chloe McIvor

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