Owning Difficult Outcomes: Navigating Medical Error Disclosure for Trainees in Accordance With ACGME Standards.

Area of Science:

• Medical Education
• Patient Safety
• Communication Skills

Background:

• The American College of Graduate Medical Education (ACGME) requires physicians to promote patient safety, including training in adverse event disclosure.
• Many trainees lack formal preparation in error disclosure, leading to inconsistent practices.
• Structured training programs are essential for fulfilling professional responsibilities and societal expectations.

Purpose of the Study:

• To implement and evaluate a simulation-based curriculum for enhancing medical error disclosure skills among trainees.
• To address the need for formal preparation in communicating adverse events to patients and families.

Main Methods:

• A simulation-based curriculum using standardized patients was integrated into a "Difficult Communications" simulation day.
• Training involved pre-briefing, simulated error disclosure encounters, and structured debriefings with faculty and peers.
• All trainees participated in at least one error disclosure simulation during their training.

Main Results:

• A significant increase in trainee confidence was observed post-simulation (4.76 ± 0.56) compared to pre-simulation (3.88 ± 0.60) (P = .0006).
• Learners highly valued the structured debriefing and the safe practice environment.
• The program involved 12-18 learners annually as primary discussants and 6-12 as observers.

Conclusions:

• The simulation-based curriculum effectively enhances trainees' medical error disclosure skills, meeting ACGME requirements.
• The program fosters patient-centered care by improving communication during adverse events.
• Future work includes expanding the curriculum and assessing real-world application of learned skills.