Pediatric Trainee Perspectives on the Decision to Disclose Medical Errors

Area of Science:

• Medical Education
• Patient Safety
• Healthcare Ethics

Background:

• Understanding factors influencing medical error disclosure is crucial for patient safety and trust.
• Pediatric trainees' perspectives on error disclosure are vital for improving reporting systems.

Purpose of the Study:

• To identify factors influencing pediatric trainees' willingness to disclose medical errors.
• To analyze how different types of safety events (serious, minor, near miss) affect disclosure decisions.

Main Methods:

• A cross-sectional anonymous survey was administered to pediatric residents and fellows.
• Clinical vignettes depicting various safety events were used to assess disclosure agreement and rationales.
• Qualitative content analysis explored themes related to disclosure decisions.

Main Results:

• Trainees showed high agreement with disclosing serious safety events (SSEs) and minor safety events (MSEs), but lower agreement for near miss safety events (NMSEs).
• Disclosure agreement was not significantly associated with trainee demographics, knowledge, or prior experiences.
• Qualitative themes included harm, parental preferences, ethical principles, and anticipatory guidance.

Conclusions:

• Disclosure rates for pediatric trainees vary significantly based on the severity of the safety event.
• Harm, parental preferences, ethics, and anticipatory guidance are key considerations in trainees' disclosure decisions.