Better training to admit mistakes could curb medical errors

University of Pennsylvania researchers are calling for the use of social psychology methods to transform the culture of medical error disclosure.
By Amy Wallace   |   May 19, 2017 at 12:31 PM

May 19 (UPI) -- A new study highlights the need for better education and training for physicians focused on admitting medical errors to improve patient outcomes.

Medical errors are the leading cause of death in the United States, causing as many as 250,000 fatalities each year. Current guidelines fall short in addressing the social psychology that influences how and when physicians and medical trainees disclose errors and how they handle the consequences of errors.

"We must transform the culture of error disclosure in the medical community from one that is often punitive to one that is restorative and supportive," Dr. Neha Vapiwala, an associate professor of Radiation Oncology and vice chair of Education in the Perelman School of Medicine at Penn, said in a press release. "And to do that, we must tend to the psychological challenges that medical professionals wrestle with when they face the possibility of disclosing an error."

Researchers found two main cognitive biases that can hinder error disclosure such as the tendency to overestimate a person's own role in a situation known as Fundamental Attribution Error, or FAE, and the tendency to overestimate impact and duration of negative consequences while underestimating the ability to recover from those circumstances known as Forecasting Error, or FE.

Strategies to overcome FAE and FE involve using elements of social psychology to transform the current culture of error disclosure such as using standardized patients -- actors who pose as patients for physicians to practice difficult patient encounters.

Virtual reality may also be an effective strategy because it can provide an immersive and realistic technology to supplement traditional curricula. Both strategies, however, come with limitations in physicians knowing that the interaction is simulated.

Researchers also recommend implementing a professional standard for trainees including a formal evaluation of skills to disclose and cope with medical errors.

"Overcoming these biases is akin to suppressing a reflex," Vapiwala said. "It requires self-awareness, practice, and most importantly, education and training."

The study was published in the journal Medical Education.

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