Physicians face psychological factors in admitting errors

Female nurse looking stressed
Efforts to encourage reporting of medical errors need to address psychological factors. (Getty/gpointstudio)

The healthcare industry has made strides to encourage physicians to report medical errors, but there’s still a failure to deal with the social psychology that goes along with making a mistake.

Physicians and other healthcare workers can feel fear, shame and guilt that come with disclosing a medical error, according to a paper in Medical Education.

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Guidelines that encourage disclosure of medical errors fall short when it comes to addressing the social psychology that influences how physicians and medical trainees disclose mistakes and how they manage the consequences, write authors Neha Vapiwala, M.D., an associate professor of radiation oncology and vice chair of education in the Perelman School of Medicine at the University of Pennsylvania, Denise LaMarra, of the school’s standardized patient program, and Jason Han, a fourth-year student.

Better education and training that focuses on these psychological challenges are needed to improve outcomes and reduce the number and severity of medical errors, they say.

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"We must transform the culture of error disclosure in the medical community from one that is often punitive to one that is restorative and supportive. And to do that, we must tend to the psychological challenges that medical professionals wrestle with when they face the possibility of disclosing an error,” Vapiwala said in an announcement.

Medical errors are a leading cause of death in the U.S., with some research suggesting that errors are responsible for as many as 250,000 fatalities each year.

The authors recommend that medical training incorporate interactions with standardized patients (actors who portray patients) to simulate difficult patient encounters and also use model interactions with family members, peers and administrators to teach behavior and coping mechanisms.

Virtual reality can also supplement traditional curricula to help doctors learn to deal with difficult patient encounters.