Physicians’ attitudes regarding the disclosure of medical errors: A qualitative study
The experiences of physicians’ errors could affect their professional practice. The aim of study was to explore physicians’ experiences of medical errors and its consequences. This was a qualitative study in which ten Brazilian physicians were selected through purposive sampling. The data were collected via semi structured interviews and analyzed through principles derived of the phenomenological method. The interview topics were around how the error occurred in their practice, its process of disclosure and consequences of medical errors. Excessive workload and difficulty communicating among physicians are some of the factors that may increase the likelihood of medical error. Not looking for help after the error was a common attitude. This may be related to the difficulty for some physicians to acquire new practices after the error, even though physicians have shown that experiencing a medical error situation has a negative impact in their lives. To disclose training and institutional practices which contribute to the dissemination of conduct favorable to the improvement of medical practice.
1. American Medical Association. (2018). Accelerating Change in Medical Education. [Accessed 12th December 2018] https://www.ama-assn.org/education/accelerating-change-medical-education
2. Barden, C.B., Specht, M.C., MacCarter, M.D., Daly, J.M., & Fahey, T.J. (2002). Effects of limited work hours on surgical training. Journal of the American College of Surgeons, 195(4), 531-538.
3. Bitencourt, A.G.V., Neves, N.M.B.C., Neves, F.B.C.S., Brasil, I.S.P.S., & Santos, L.S.C. (2007). Análise do erro médico em processos ético-profissionais: implicações na educação médica. Revista Brasileira de Educação Médica, 31, 223-228.
4. Dunn, L.B., Moutier, C., Green Hammond, K.A., Lehrmann, J., & Roberts, L.W. (2008). Personal Health Care of Residents: Preferences for Care Outside of the Training Institution. Academic Psychiatry, 32(1), 20-30.
5. Federal Council of Medicine. (2009). CFM Resolution no. 1931. September 17, 2009. Brasilia 4 p.
6. Filho, B.L., & Cassenote, A.J.F. (2018). O Exame do CREMESP. Sao Paulo: Conselho Regional de Medicina do Estado de São Paulo.
7. Galam, E. (2012). L’Erreur médicale, le burnout et le soignant. Paris: Springer.
8. Gallagher, T.H., Studdert, D., & Levinson, W. (2007). Disclosing harmful medical errors to patients. New England Journal of Medicine, 26, 2713-2719.
9. Gallagher, T.H., Waterman, A.D., Ebers, A.G., Fraser, V.J., & Levinson, W. (2003). Patients’ and physicians’ attitudes regarding the disclosure of medical errors. JAMA, 289, 1001-1007.
10. Giorgi, A., & Sousa, D. (2010). Método fenomenológico de investigação em Psicologia. Lisbon: Fim do seculo.
11. Giostri, H.T. (2002). Erro médico à luz da jurisprudência comentada. Curitiba: Juruá pp. 136.
12. Goldstein, M.J., Kim, E., Widmann, W.D., & Hardy, M.A. (2004). A 360 degrees evaluation of a night- oat system for general surgery: a response to mandated work-hours reduction. Current Surgery, 61, 445-451.
13. Gomes, A.P., & Rego, S. (2011). Transformação da educação médica: é possível formar um novo médico a partir de mudanças no método de ensino-aprendizagem? Revista Brasileira de Educação Médica, 35, 557-566.
14. Grange, P., & Papilon, F. (2008). Erreurs médicales. Paris: Nil.
15. Hiatt, H. (1992). Medical malpractice. Bulletin of the New York Academy of Medicine, 68(2), 254–264.
16. Institute of Medicine (US) Committee on Quality of Health Care in America, Kohn, L.T., Corrigan, J.M., & Donaldson, M.S. (Eds.), (2000). To err is human: building a safer health system. Washington: National Academy Press.
17. Laranjeira, R., & Alves, H. (2014). Médicos dependentes e com problemas psicológicos. Journal Cremesp 198.
18. Mendonca, V., & Schmidt, M. (2019). Disclosure: possibility to discuss medical error. International Archives of Internal Medicine, 3, 1-5.
19. Mendonca, V., Gallagher, T., & Oliveira, R. (2018). The Function of Disclosing Medical Errors: New Cultural Challenges for Physicians. HEC Forum, 30.
20. Scheffer, M. (2013). Demografia médica no Brasil. São Paulo: Conselho Federal de Medicina e Conselho Regional de Medicina do Estado de São Paulo.
21. Stewart, S.M., Betson, C., Marshall, I., Wong, C.M., Lee, P.W., & Lam, T.H. (2005). Stress and vulnerability in medical students. Medical Education, 29(2), 119-127.
22. Truog, R.D., Browning, D.M., Johnson, J.A., & Gallagher, T.H. (2011). Talking with patients and families about medical error: a guide for education and practice. Baltimore: The Johns Hopkins University Press.
23. Weerakkody, R.A., Cheshire, N.J., Riga, C., Lear, R., Hamady, M.S., Moorth, K., Darz, A.W., Vincen, C., & Bicknell, C.D. (2013). Surgical technology and operating-room safety failures: a systematic review of quantitative studies. BMJ Quality & Safety, 22(9), 710-718.
24. Wu, A.W., McCay, L., Levinson, W., Iedema, R., Wallace, G., Boyle, D.J., & McDonald, T.B. Bismark, M.M., Kraman, S.S., Forbes, E., Conway, J.B., & Gallagher, T.H. (2017). Disclosing adverse events to patients: International norms and trends. Journal of Patient Safety,13(1), 43–49.