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How house officers cope with their mistakes
A W Wu1, S Folkman, S J McPhee
1Department of Health Policy and Management, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland 21205.
The Western Journal of Medicine
|November 1, 1993
Summary
House officers experience significant distress after medical mistakes. Accepting responsibility aids constructive practice changes, while avoidance leads to defensive ones, highlighting the need for educator support.
Area of Science:
- Medical Education
- Psychology of Healthcare Professionals
Background:
- Medical errors are inevitable and significantly impact house officers.
- Understanding coping mechanisms is crucial for effective medical training and support.
Purpose of the Study:
- To investigate how internal medicine house officers cope with serious medical mistakes.
- To inform medical educators on how to best support trainees after errors.
Main Methods:
- Anonymous questionnaire distributed to 254 internal medicine house officers.
- 45% (N=114) reported and described their most significant medical mistake and response.
- Multivariate analysis used to correlate coping strategies with practice changes and emotional distress.
Main Results:
- House officers experienced substantial emotional distress following medical errors.
- Coping through accepting responsibility correlated with constructive practice changes but increased distress.
- Coping via escape-avoidance correlated with defensive practice changes.
Conclusions:
- Medical educators should offer specific guidance to prevent error recurrence.
- Emotional support and validation of distress are essential for house officers learning from mistakes.
- Distress is a normal part of the learning process after medical errors.