Association of Perceived Medical Errors With Resident Distress and Empathy

Abstract

Self-perceived medical errors are common among internal medicine residents and are associated with substantial subsequent personal distress. Personal distress and decreased empathy are also associated with increased odds of future self-perceived errors, suggesting that perceived errors and distress may be related in a reciprocal cycle.

Burned Out at the Bedside: Patient Perceptions of Physician Burnout in an Internal Medicine Resident Continuity Clinic

“…This is contrary to previous studies that used only physicianreported data to link burnout with low levels of empathy, 6,7,19 patient-centered doctoring, 2,19 and quality of care. 4,5 Higher scores on the empathy (CARE) and enablement (PEI) instruments used in our study predicted symptom improvement and enhanced well-being in patients at subsequent office encounters. [9][10][11][12] Therefore, our results provide some reassurance that quality of care from residents with higher levels of burnout, as manifested by more depersonalizing attitudes towards patients, is not perceived as inferior by the patients they care for.…”

“…1 It is measured using a validated instrument, 1 and reported by 50-75 % of resident physicians. [2][3][4] Burnedout residents self-report increased rates of medical errors, 4,5 suboptimal patient care, 2 and reduced empathy. 6,7 A few studies have tried to substantiate these findings with independent observational data but have not provided confirmatory evidence.…”

Apologies and Medical Error

“…Physicians, like patients, are profoundly affected by medical errors; physicians worry about harm caused to patients; are anxious about the consequences of error for their reputations, fearing that patients and colleagues will no longer trust and respect them; experience distress, feelings of guilt, and loss of self-confidence; and are anxious about the possibility of a lawsuit [6,13,20,57]. Indeed, physicians describe the ''sickening realization of making a bad mistake'' [60] and the sense of dread on realizing that one has made an error [13].…”

Stress Management and Resilience Training Among Department of Medicine Faculty: A Pilot Randomized Clinical Trial

“…[1][2][3] Physician distress is related to numerous factors, including a loss of control, workload, specialty choice, experience with suffering, college loans, poor self-care, maladaptive coping strategies and stressful life events. [4][5][6][7] Academic physicians are especially at high risk for experiencing stress because of multiple demands and expectations. 8 Negative effects of physician distress include decreasing level of satisfaction, attrition from academic practice, loss of empathy, decrease in idealism, poor mental health, and burnout.…”

“…8 Negative effects of physician distress include decreasing level of satisfaction, attrition from academic practice, loss of empathy, decrease in idealism, poor mental health, and burnout. 7,9 Burnout may affect an estimated 25-60% of physicians. 7 -1 0 Decreased physician well-being also increases risk of medical errors.…”