Characterizing Resident Preferences for Faculty Involvement and Support in Disclosing Medical Errors to Patients.

Abstract

Residents may be commonly involved with medical errors and need faculty support when disclosing these to patients. We characterized residents' preferences for faculty involvement and support during the error disclosure process. We surveyed residents from internal medicine, pediatrics, emergency medicine, general and orthopedic surgery, and obstetrics and gynecology residency programs at the University of Toronto in 2014-2015 about their preferences for faculty involvement across a variety of different error scenarios (ie, error type, severity, and proximity) and for elements of support they perceive to be most helpful during the disclosure process. Over 90% of the 192 respondents (N = 538, response rate 36%) wanted direct involvement in the error disclosure process, irrespective of type or severity of the error. Residents were relatively comfortable disclosing prescription and communication errors without direct faculty involvement but preferred faculty involvement when disclosing diagnostic and management errors. When errors were severe, many residents still wanted to be involved but preferred having faculty lead the disclosure. Residents particularly wanted to participate in the process when they felt responsible for the error. Residents highly valued receiving faculty advice on how to manage consequences and how to prevent future errors in preparing for disclosure, as well as receiving postdisclosure feedback and personal support. Residents are willing participants in the error disclosure process and have specific preferences for faculty involvement and support. These findings can inform faculty development to ensure appropriate support and supervision for residents when disclosing errors to patients.