Resident Education in Medical Errors

Abstract

Background: A 2001 policy statement from the American College of Emergency Physicians encouraged ef- fective and standardized system of medical error reporting for the purpose of aiding practitioners and institutions in efforts to improve safety. Study objective: To evaluate current curricula of U.S. medical residency programs regarding medical errors. Methods: A 41-item questionnaire was e-mailed to chief residents and residency directors of Accreditation Council for Graduate Medical Education (ACGME)-approved U.S. residency programs. Data were collected regarding demographics and residency training in medical error. Emergency medicine (EM) and non-EM residency programs were compared. Results: 808 educators from 44 states responded; 13% were from EM residency programs. When comparing EM and non- EM residency curricula, there was no significant difference in mean number of lectures on medical error (4 vs. 5, p=0.24); however, more EM respondents reported providing instruction on risk communication (99 vs. 85%, p<0.05), medical li- ability insurance (53 vs. 18%, p<0.05), malpractice litigation (55 vs. 18%, p<0.05), medical record documentation (61 vs. 25%, p<0.05), risk management (49 vs. 19%, p<0.05), expert witness testimony (60 vs. 11%, p<0.05), and malpractice crisis (58 vs. 17%, p<0.05). Also, more EM respondents reported that they knew whether there was a mandatory medical error reporting statute (48 vs. 31%, p<0.05) or an apology statute in their state (31 vs. 16%, p<0.05). Conclusion: ACGME-approved residency program curricula include variable components of education in medical errors; significant differences between EM and non-EM residency programs exist.