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Senior Citizen Health & Medicine
Distress from Medical Errors Common among Resident
Physicians
One-third report major medical error during study
period
September 6, 2006 - About one-third of surveyed
resident physicians report committing at least one major error during
the study period, often associated with substantial personal distress,
according to a study in the September 6 issue of
JAMA,
a theme issue on medical education.
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Medical errors and patient safety are an important
concern for patients and physicians. The proportion of hospitalized
patients affected by medical errors has been estimated to be 5 percent
to 10 percent, although it has approached 50 percent in some studies,
according to background information in the article.
The illness, death, and financial costs of these
events may be great. Many reports on medical errors have focused on the
rate at which errors affect patients. Less is known about the proportion
of physicians who commit errors.
Colin P. West, M.D., Ph.D., of the Mayo Clinic
College of Medicine, Rochester, Minn., and colleagues evaluated the
frequency of perceived medical errors among internal medicine residents
and measured the association of these medical errors with resident
quality of life (QOL), burnout, symptoms of depression, and empathy.
The study included data provided by 184 (84
percent) of 219 eligible internal medicine residents at Mayo Clinic
Rochester. Participants began training in the 2003-2004, 2004-2005, and
2005-2006 academic years and completed surveys quarterly through May
2006.
Surveys included self-assessment of medical errors
and quality of life every 3 months and measures of burnout
(depersonalization, emotional exhaustion, and personal accomplishment)
and symptoms of depression every 6 months.
The researchers found that overall,
● 34 percent of study participants reported at least 1 major medical
error during the study period, and
● 43 percent of residents completing at least 1 year of training
reported errors.
Of the participants,
● 20 percent reported 1 error,
● 6 percent reported 2 errors, and
● 8 percent reported 3 or more errors during the study period.
Making a medical error in the previous 3 months was
reported by an average of 14.7 percent of participants at each quarter.
Self-perceived medical errors were associated with a subsequent decrease
in quality of life and worsened measures in all domains of burnout.
Participants who reported self-perceived errors
were about 3 times more likely to screen positive for depression. In
addition, increased burnout in all domains and reduced empathy were
associated with increased odds of self-perceived error in the following
3 months.
“Our results also suggest that residency programs
should ensure that efforts are in place to prevent, identify, and treat
burnout and to promote empathy and well-being for the welfare of
residents and patients,” the authors write.
“A majority of residents discuss their errors with
colleagues, supervising faculty, or friends and family, but formal
programs to provide additional support for physicians who make errors
appear warranted. Further investigation to identify the most effective
post-error support mechanisms is needed in parallel with ongoing system
efforts to reduce error rates and resident distress,” the researchers
conclude.
Editor's Note: This work was supported by
a Medicine Innovation Development and Advancement System grant from the
Mayo Clinic Department of Medicine.
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