Abstract
Background
Medical error (ME) remains central to discussions regarding patient’s safety and its frequency appears high in surgical specialties because of some peculiarities. We set out to study the perception of surgical residents about medical errors, their ability to recognize them and predisposition to disclosing their errors.
Methods
This was a cross-sectional study among surgical residents at the University College Hospital, Nigeria. Data about their knowledge, perception and recognition of medical errors were obtained. Knowledge and practice of medical error disclosure was also examined. Each of these was scored on Likert scale and scores categorized. Chi-square test and logistic regression were used for analysis with p at <0.05.
Results
92 residents participated and 11(12.0%) were females. 32.6% of the respondents had less knowledge about medical errors and these were significantly junior residents. Residents with poor perception about ME were 43.5% and recent involvement with ME was significantly associated with good perception about ME. Delay in obtaining consultation and delay in diagnosis were identified respectively as MEs by only 40(43.5%) and 31(33.7) of the participants. While 82(89.1%) agreed that all errors should be reported to the consultant, only 20(21.7%) believed patients/relatives should be informed of all errors, while 49(53.3%) were well disposed to disclosing ME. Only 4(4.3%) residents had a formal training on ME.
Conclusions
Knowledge of ME was low among junior residents and residents are less likely to disclose error to patients/relatives. A formal training on ME will impact on their recognition, practice, and disclosure of ME.
Similar content being viewed by others
References
Leape LL, Berwick DM (2005) Five years after to err is human: what have we learned? JAMA 293:2384–2390
Institute of Medicine Committee on Quality of Health Care in A (2000) In: Kohn LT, Corrigan JM, Donaldson MS (eds) To Err is human: building a safer health system, National Academies Press (US)Copyright 2000 by the National Academy of Sciences. All rights reserved., Washington (DC)
Makary MA, Daniel M (2016) Medical error-the third leading cause of death in the US. BMJ 353:i2139
Brennan TA, Leape LL, Laird NM et al (2004) Incidence of adverse events and negligence in hospitalized patients: results of the Harvard Medical Practice Study I. 1991. Qual Saf Health Care 13:145–151 (discussion 151–142)
Weingart SN, Mc LWR, Gibberd RW et al (2000) Epidemiology of medical error. Western J Med 172:390–393
Grober ED, Bohnen JM (2005) Defining medical error. Can j Surg 48:39–44
Bosma E, Veen EJ, Roukema JA (2011) Incidence, nature and impact of error in surgery. Br J Surg 98:1654–1659
Bari A, Khan RA, Rathore AW (2016) Medical errors; causes, consequences, emotional response and resulting behavioral change. Pak J Med Sci 32:523–528
Balogun JA, Bramall AN, Bernstein M (2015) How surgical trainees handle catastrophic errors: a qualitative study. J Surg Educ 72:1179–1184
Lipira LE, Gallagher TH (2014) Disclosure of adverse events and errors in surgical care: challenges and strategies for improvement. World J Surg 38:1614–1621
Antiel RM, Blinman TA, Rentea RM et al (2016) When a surgical colleague makes an error. Pediatrics 137:e20153828
Tevlin R, Doherty E, Traynor O (2013) Improving disclosure and management of medical error—an opportunity to transform the surgeons of tomorrow. Surgeon 11:338–343
White AA, Gallagher TH, Krauss MJ et al (2008) The attitudes and experiences of trainees regarding disclosing medical errors to patients. Acad Med 83:250–256
Martinez W, Lehmann LS (2013) The “hidden curriculum” and residents’ attitudes about medical error disclosure: comparison of surgical and nonsurgical residents. J Am Coll Surg 217:1145–1150
Helo S, Moulton C-AE (2017) Complications: acknowledging, managing, and coping with human error. Transl Androl Urol 6:773–782
Crook ED, Stellini M, Levine D et al (2004) Medical errors and the trainee: ethical concerns. Am J Med Sci 327:33–37
Ogunleye OO, Oreagba IA, Falade C et al (2016) Medication errors among health professionals in Nigeria: a national survey. Int J Risk Saf Med 28:77–91
Ogundiran TO, Adebamowo CA (2012) Surgeon-patient information disclosure practices in southwestern Nigeria. Med Princ Pract 21:238–243
Ushie BA, Salami KK, Jegede AS et al (2013) Patients’ knowledge and perceived reactions to medical errors in a tertiary health facility in Nigeria. African health sciences 13:820–828
Rebasa P, Mora L, Luna A et al (2009) Continuous monitoring of adverse events: influence on the quality of care and the incidence of errors in general surgery. World J Surg 33:191–198
Stone S, Bernstein M (2007) Prospective error recording in surgery: an analysis of 1108 elective neurosurgical cases. Neurosurgery 60:1075–1080 (discussion 1080–1072)
Nishizaki Y, Shinozaki T, Kinoshita K et al (2017) Awareness of diagnostic error among japanese residents: a nationwide study. J Gen Int Med 33:445–448
Penson RT, Svendsen SS, Chabner BA et al (2001) Medical mistakes: a workshop on personal perspectives. Oncologist 6:92–99
Gallagher TH, Waterman AD, Garbutt JM et al (2006) US and Canadian physicians’ attitudes and experiences regarding disclosing errors to patients. Arch Intern Med 166:1605–1611
Ghalandarpoorattar SM, Kaviani A, Asghari F (2012) Medical error disclosure: the gap between attitude and practice. Postgrad Med J 88:130–133
Cox CL, Fritz Z (2016) Should non-disclosures be considered as morally equivalent to lies within the doctor-patient relationship? J Med Ethics 42:632–635
Etchegaray JM, Gallagher TH, Bell SK et al (2012) Error disclosure: a new domain for safety culture assessment. BMJ Qual Saf 21:594–599
Gallagher TH, Garbutt JM, Waterman AD et al (2006) Choosing your words carefully: how physicians would disclose harmful medical errors to patients. Arch Intern Med 166:1585–1593
Chan DK, Gallagher TH, Reznick R et al (2005) How surgeons disclose medical errors to patients: a study using standardized patients. Surgery 138:851–858
Martinez W, Hickson GB, Miller BM et al (2014) Role-modeling and medical error disclosure: a national survey of trainees. Acad Med 89:482–489
Fischer MA, Mazor KM, Baril J et al (2006) Learning from mistakes. Factors that influence how students and residents learn from medical errors. J Gen Intern Med 21:419–423
Wang AS, Eisen DB (2013) Surgical complications: disclosing adverse events and medical errors. J Am Acad Dermatol 68:144–146
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Balogun, J.A., Adekanmbi, A. & Balogun, F.M. Recognition and Disclosure of Medical Errors Among Residents in Surgical Specialties in a Tertiary Hospital in Ibadan. World J Surg 43, 717–722 (2019). https://doi.org/10.1007/s00268-018-4836-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00268-018-4836-y