An educational programme for error awareness in acute trauma for junior doctors

Abstract

Background. In resource-poor environments of the developing world, young and inexperienced interns and community service doctors are often responsible for treating trauma patients without sufficient supervision. Time and experience are required for competency to develop, but in the understaffed environment of many hospitals time is often a constraint. Educational interventions are needed to accelerate competency development of the novice doctor. Method. The researchers designed an intervention using real cases and error theory to expand young doctors’ experiences of common trauma errors made in our setting. We analysed cases at the regular morbidity and mortality meetings and selected cases where error contributed to the condition of the patient. Using error theory, these cases were presented to doctors with the objective to increase error awareness. To assess the success of this intervention, three doctors who were exposed to the intervention and three who were not exposed to it were included in the study using a structured interview. Results. This study demonstrated that interns who had been exposed to the intervention had a broader understanding of how errors can compound a patient’s pathology and are often the result of systematic rather than individual failure. Conclusion. The researchers focused on the rationale for and the development of an intervention for novice doctors to expose them to trauma experiences in the framework of understanding error. The immediate success of the intervention is illustrated in the structured interviews. Further development of this intervention and more formal research into its pedagogical value are planned after formalisation of the intervention into a teaching curriculum for trauma doctors. This educational initiative will have to be part of a comprehensive multifaceted quality-improvement programme if it hopes to be successful.