Experience in reporting a medical error to patients: a qualitative study

Abstract

The problem of informing the patient about a medical error is one of the most difficult in the theory and practice of doctor-patient interaction: the methodology is not developed enough, and the experience of doctors is poorly studied. The article reveals the main provisions of the CONES Protocol, which is used by doctors in the international community to inform the patient about a medical error. In this work, we studied and analyzed interviews (n=30) of doctors of various medical fields, where they revealed their own experience in informing the patient about a medical error, analyzing the factors that caused errors, ways to inform and respond to patients. The content of the doctors’ experience was compared with the CONES Protocol using qualitative deductive content analysis. For coding and categorizing the text units of the interviews we used OpenCode 4.02 software. The results of the study showed that most doctors had medical errors in their medical experience. Respondents indicated inattention, insufficient level of competence and high workload among the main factors that cause errors. It is revealed that most doctors had difficulties when informing the patient about a medical error. Sometimes they avoided it, which was due to the lack of readiness to communicate with patients in this situation, caused by the lack of training in appropriate communication skills during study at a medical university. Matching the respondents’ experience of reporting a medical error to patients according to the CONES Protocol showed that the existing experience of doctors most closely corresponds to the actions that involves creating the necessary context for the communication and stating the fact of the error, and least of all corresponds to preparing the patient for the message, demonstrating empathy and explaining further actions of the doctor. In general, content of the analyzed experience in reporting a medical error to the patient and the Protocol do not conflict with each other. It can be assumed that training residents and doctors in the communication privacy management theory, which includes a two-stage plan for disclosure of medical errors, as well as adherence to the CONES Protocol, will allow them to conduct a dialogue with the patient about a medical error in an orderly, fast and efficient manner, observing ethical principles, while maintaining respect and trust between the participants.