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Formalizing the Hidden Curriculum of Performance Enhancing Errors.

Fiona M Kerray1, Steven J Yule2, Andrew L Tambyraja1

  • 1Department of Clinical Surgery, The University of Edinburgh, Edinburgh, Scotland; Edinburgh Vascular Service, Royal Infirmary of Edinburgh, Edinburgh, Scotland.

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|March 2, 2023
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Summary
This summary is machine-generated.

Surgeons need structured ways to discuss errors. Integrating error management theory and human factors science into surgical training can improve performance and reduce the stigma of mistakes.

Keywords:
ergonomicserror management theoryhuman factors scienceperformance feedbacksurgical training

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Area of Science:

  • Medical Education
  • Human Factors Science
  • Surgical Performance

Background:

  • Error is an inevitable aspect of surgery, yet remains difficult to discuss due to its link with patient outcomes.
  • Current surgical training lacks standardized methods for recognizing and reflecting on critical errors (sentinel events).
  • The prevailing educational approach focuses on error avoidance rather than constructive error management.

Purpose of the Study:

  • To highlight the need for a standardized tool to guide a safe and constructive response to surgical errors.
  • To advocate for the integration of error management theory (EMT) into surgical training.
  • To propose the development of a national human factors science/ergonomics (HFE) curriculum within the EMT framework.

Main Methods:

  • Reviewing the current educational paradigm in surgical training regarding error.
  • Examining the evidence base for incorporating error management theory (EMT) into surgical education.
  • Exploring the role of human factors science/ergonomics (HFE) in surgical performance and error reflection.

Main Results:

  • Error management theory (EMT) has shown potential to improve long-term skill acquisition and training outcomes.
  • Human factors science/ergonomics (HFE) offers a framework for understanding the interplay between psychology, engineering, and performance in surgery.
  • A common language through HFE and EMT can facilitate objective performance reflections and reduce the stigma of fallibility.

Conclusions:

  • A structured approach to error, incorporating EMT and HFE, is necessary for surgical training.
  • Developing a national HFE curriculum within an EMT context can enhance surgical performance and address the stigma of errors.
  • Harnessing the performance-enhancing aspects of errors, similar to successes, is crucial for surgical development.