Residents' perspectives on their training in managing errors in health care: an explorative qualitative study

住院医师对医疗差错管理培训的看法:一项探索性定性研究

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Abstract

OBJECTIVES: This study investigated the perspectives of residents on training in error managing. The research question was: how do residents perceive and experience their training in handling errors in clinical practice? METHODS: The study used a qualitative exploratory design to gain insight into the residents' experiences. The data consisted in seven virtual focus groups with 22 Danish residents from 11 specialties at various educational levels, i.e. from first to fourth year of their training. The data were transcribed and analyzed using reflexive thematic analysis. RESULTS: The analysis showed three themes: 1) formal education, 2) culture and clinical context, and 3) the need for more training. The residents reported learning primarily about the legal aspects of errors, complaints, and the adverse events reporting system. They emphasized the need for practical training in error disclosure and managing emotional reactions to errors. Training in error managing was described as sporadic in specialist training, often contingent on departmental culture and individual supervisors. CONCLUSION: The study revealed that residents perceive their training in error handling as inadequate, particularly in terms of disclosure, emotional reactions, and victim support, and identified the need for greater emphasis on these aspects in both undergraduate education and postgraduate training. The Danish framework for physician roles and specialist training curricula should be revised and a more open culture regarding medical errors fostered. Furthermore, supervisor training is crucial as training in error management should be integrated into the clinical setting where errors occur.

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