Error training: Missing link in surgical education

Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. .
Surgery (Impact Factor: 3.11). 11/2011; 151(2):139-45. DOI: 10.1016/j.surg.2011.08.008
Source: PubMed

ABSTRACT PEOPLE MAKE MISTAKES. Human error is inevitable and must be anticipated, especially in environ-ments where novices are developing new knowl-edge and skills. 1 In medical education, faculty members are charged with supervising their resi-dents to minimize chances of patient care errors. This is no small challenge for faculty given the con-sequences of errors to patients, the psychological cost to learners, and the ramifications for the fac-ulty member and hospital from the fiscal, resource, and medicolegal perspectives. Yet, if decision-making and technical errors are bound to occur during a physician's career because of human in-fallibility, and residents have uneven and limited exposure to errors because of responsible faculty oversight, how will they graduate fully prepared to recognize and manage an error when one does occur? Satava 2 explained that faculty mem-bers spend so much time teaching residents how to do the correct thing that they forget to explicitly teach how to avoid errors or fix it when one has oc-curred. Residents encounter errors during their residency but this ''catch as catch can'' strategy can-not provide a sufficient and balanced array of op-portunities to hone the perceptual, cognitive, and technical skills needed to prevent, recognize, or manage the range of potential errors. 3 The purpose of this paper is to: (1) justify the importance of integrating planned instruction about errors into surgical residency curricula despite reduced work hours and an already over-crowded residency curricula; (2) discuss the scope of what could be taught to residents about errors; (3) describe instructional models and strategies for teaching error prevention, recognition, and man-agement strategies; and (4) suggest areas for future research and development to strengthen this aspect of clinical education that bears such critical implications for patient safety.

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