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A new way of relating: perceptions associated with a team-based error disclosure simulation intervention
  1. Lianne Jeffs1,
  2. Sherry Espin2,
  3. Sarah E Shannon3,
  4. Wendy Levinson1,4,
  5. Melanie Kazman Kohn1,
  6. Lorelei Lingard5
  1. 1Keenan Research Centre of the Li Ka Shing Knowledge Institute, St Michael's, Toronto, Canada
  2. 2Ryerson University, Toronto, Canada
  3. 3University of Washington, Washington, USA
  4. 4University of Toronto, Toronto, Canada
  5. 5University of Western Ontario, Centre for Education Research & Innovation, London, Canada
  1. Correspondence to Miss Lianne P Jeffs, St Michael's Hospital, Room 5-060 Bond Wing, 30 Bond Street, Toronto M5B 1W8, Canada; jeffsl{at}


Background Despite the call for open and team-based approaches to error disclosure, the participation beyond physicians and managers is not a common practice in health care settings. Moreover, within the growing literature base on error disclosure, team-based error disclosure is an emerging concept. To address this knowledge gap, a study was undertaken to explore the perceptions associated with an educational simulation intervention for team-based error disclosure.

Methods A qualitative study that involved analysis of data obtained from semi-structured interviews with a sample of 6 physicians, 6 surgeons, and 12 nurses recruited from the three participating hospitals.

Results Perceptions from study participants elucidated a tension between team-based error disclosure as an unrealistic, forced practice and as a realistic, beneficial practice. This tension was highly contextual and differentiated by study participants' perceptions of the nature of the error; patient's preferences; and prevailing cultural and professional norms. Regardless of the view, study participants described the simulation experience as a new way of relating that departed from existing practice.

Conclusions Study findings revealed that a team-based approach to disclosure is not realistic or necessary for all error situations, such as when the error involves a single discipline. However, when the error involves a variety of health care professionals interacting with the patient, a team-based approach is beneficial to them and the patient. Further work is required by researchers and administrators to develop and test out interventions that enable health care professionals to practice team-based error disclosure in a safe and supported environment.

  • Medical error
  • qualitative research
  • simulationsurgery
  • team training

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  • Funding Canadian Patient Safety Institute.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Research Ethics Board at Ryerson University and the institutional Research Ethics Board at the three participating study sites.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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