Study explores how physicians communicate mistakes

Programs needed to teach surgeons how to communicate more effectively
Nov 17/05
by Karen Kelly (about)

While pressure grows on physicians to admit errors, medical professionals must be taught how to communicate their mistakes, says U of T research.

“The patient safety movement calls for disclosure, but it’s a very difficult conversation to have and physicians often fear litigation and haven’t had any training in disclosing errors,” says Professor Wendy Levinson of the Department of Medicine.

The study, published in the November issue of Surgery, explored how 30 academic surgeons disclosed surgical errors to patients using standardized patients (actors playing the role of patients). The surgeons discussed error scenarios such as wrong-side lumpectomy and retained surgical sponge in the abdomen, with a total of 60 encounters. The encounters were then ranked using a scale developed to rate five communication elements of effective disclosure. Half of the encounters took place face-to-face; the remainder by videoconference.

The results of the encounters showed that surgeons used the word error or mistake in only 57 per cent of disclosure conversations, took responsibility for their error 65 per cent of the time and offered a verbal apology only 47 per cent of the time. Eight per cent of surgeons discussed how similar errors would be prevented and 20 per cent offered a second opinion.

“The good news is that after more practice with difficult conversations, the surgeons became more skilled and forthcoming,” says Levinson, the study’s lead author. “In reality, physicians are not given as many opportunities to practise admitting mistakes. It’s important that we develop programs to teach surgeons how to communicate more effectively.”

This research was funded by the American Board of Medical Specialties and the Agency for Healthcare Research and Quality.

Contact:

Professor Wendy Levinson, Department of Medicine, 416-978-6430, wendy.levinson@utoronto.ca


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