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Responding to Surgical Errors: From Psychological Impact to Disclosure-A Systematic Review
Isolde M Busch1, Veronica Marinelli2,3, Olga Maggioni4
1Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Annals of Surgical Oncology
|June 6, 2026
Summary
Surgical errors cause significant distress, with guilt and anxiety common among staff. Improved disclosure protocols and psychological support are needed to manage adverse events and protect clinicians.
Area of Science:
- Medical Error Management
- Patient Safety
- Surgical Psychology
Background:
- Transparent management of surgical errors and adverse events (AE) is crucial for patient safety and staff well-being.
- Understanding the clinician experience of AE disclosure is vital for improving healthcare systems.
Purpose of the Study:
- To systematically review the evidence on how surgical errors and AE are experienced and disclosed.
- To focus on the psychological impact on clinicians, coping strategies, support resources, and disclosure barriers.
Main Methods:
- A systematic search was conducted across major databases (PubMed, PsycINFO, CINAHL, WoS Core Collection) without date restrictions.
- Two independent reviewers screened studies, assessed quality, and extracted data for narrative synthesis.
Main Results:
- 30 studies (11,723 participants) revealed significant emotional distress in surgical staff post-AE, with high rates of guilt and anxiety.
- Disclosure rates were inconsistent (17-62%), hindered by fear of litigation, unclear procedures, and hierarchy.
- Formal psychological support was accessed by only 1.6-7% of staff.
Conclusions:
- Substantial psychological impact on clinicians necessitates organizational strategies for staff well-being.
- Limited evidence exists on psychological factors in disclosure; clearer protocols, communication training, and support are recommended.
- Enhanced error management can reduce distress and promote patient-centered care, especially in complex fields like oncological surgery.
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