Original communicationHow surgeons disclose medical errors to patients: A study using standardized patients
Section snippets
Methods
Each of the 30 surgeons was assigned randomly to meet with SPs portraying 2 of the 3 error scenarios described below. Half of the surgeon-SP encounters took place face-to-face, while the remainder occurred by videoconference. In prior work, the investigators found that videoconferenced SPs were a feasible and well-accepted approach for assessing surgeons' communication skills.20 The surgeon read a brief vignette describing the error and then was instructed to discuss what had happened with the
Results
Inter-rater reliabilities of the 5-item aggregate and overall impression scores between SP and physician raters were good to excellent (.58 to .83). Internal consistencies of the rating scale were moderate to high (.42 to .84). Both inter-rater reliabilities and internal consistencies were similar between the 2 media. Differences in the individual item scores, the 5-item aggregate scores, and the overall impression scores were not significant between the face-to-face and videoconferencing
Comment
Surgeons face a difficult dilemma when deciding whether and how to disclose a harmful error to a patient. Our study, the first to assess how surgeons currently disclose harmful errors to patients, suggests that surgeons vary widely in their approach to this difficult task. In many cases, surgeons failed to use recommended error disclosure skills, such as explicitly stating that an error took place, apologizing, and discussing plans for error prevention. These disclosure shortcomings were
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Cited by (0)
Supported by grants from the American Board of Medical Specialties and the Agency for Healthcare Research and Quality (1U18HS1189801, 1K08HS01401201). Dr Gallagher also received support from the Greenwall Foundation Faculty Scholars in Bioethics Program.
All authors participated in the study design, collection of data, interpretation of results and writing or review of the paper.