When Bad Things Happen: Training Medical Students to Anticipate the Aftermath of Medical Errors

Abstract

Objective Medical errors affect trainees. Existing curricula emphasize tenets of patient safety but rarely address the impact of medical errors on health care providers, particularly at the undergraduate level. The authors developed an interactive session exploring the professional and personal effects of medical errors for 300 second-year medical students. Methods The session utilized case-based learning, small group discussion, and video vignettes. Physicians in multiple specialties were interviewed, sharing narrative accounts of their experience with medical errors and adverse events. Discussions were facilitated by local physicians, who delivered content and shared personal anecdotes. Surveys using a 5-point Likert scale were conducted before and after the session. Results Pre- and post-test surveys resulted in 91 responses in 2016 and 174 in 2017. In 2016, results showed significant change in student responses by 0.34 units (SD 0.35 units; p < 0.001). Two survey items addressing student awareness and three items addressing confidence were significant. The domains assessing students’ attitudes and knowledge regarding medical errors were not significant. In 2017, the overall mean change was 0.33 with a lower standard error, 0.03 ( p < 0.001), showing significance in both years the session was delivered. Conclusion A 1-h, small-group session increased medical students’ understanding of the impact of medical errors and adverse events on providers and the supportive resources available. Recruitment of local faculty to facilitate discussions and share personal anecdotes enhanced the success of the session.

Unveiling the hidden struggle of healthcare students as second victims through a systematic review

“…Mousinho Tavares et al (2022) found that the students did not know about the organizational support or protocols available to students who become second victims of patient safety incidents [ 42 ]. In 2020, in the USA, interactive sessions exploring the professional and personal effects of medical errors were designed to explain to medical students the support resources available to them [ 31 ].…”

“…This training improved confidence in recognizing shame, distinguishing it from guilt, identifying shame reactions, and being willing to seek help from others. In 2020, Musunur et al showed that an hour-long interactive group session for medical students in the USA increased awareness of available resources in coping with medical errors and self-reported confidence in detecting and coping with medical errors [ 31 ]. A 2022 Italian cross-sectional study on healthcare students and medical residents as second victims found no data on structured programs included in medical residency programs/specialization schools to support residents after the occurrence of an adverse event.…”

“…Over one-third of the studies have employed quasi-experimental designs with pre-post measures, although most studies have relied on qualitative methodologies to explore students' responses to specific issues [ 19 , 28 , 29 , 31 , 33 , 34 , 41 , 44 ]. These investigations do allow us to assert that we understand the problem, have quantified it, and have ideas to address it, but we lack a consensus-based and tested framework to ensure the capacity to confront these situations in the students.…”

“…Furthermore, during their training period, they may be affected by witnessing the consequences of AEs experienced by patients, which can significantly influence how professionals approach their work (e.g., defensive practices) [ 58 ] and their overall experience (e.g., detachment) [ 59 ]. There are proposals for toolkits that have proven to be useful [ 31 , 60 ], and the data clearly indicate that educators should not delay further including educational content for their students to deal with errors and other highly stressful situations in healthcare practice [ 52 ]. Adapting measures within the academic environment and at healthcare facilities that host students in training programs is a task that we should no longer postpone.…”

Medical students’ experiences, perceptions, and management of second victim: An interview study

“…Furthermore, poor role-modelling has been reported to impact students' wellbeing negatively (22). Students' self-reported awareness and con dence regarding adverse events and errors increased after a session containing video vignettes of physicians sharing experiences with errors (23).…”