Shared decision making: Moving from theorization to applied research and hopefully to clinical practice

Abstract

Medical errors are a nearly universal experience for physicians. An error that harms a patient is one of the most difficult experiences that physicians face. Difficult experiences can result in growth. This study investigates how physicians coped positively with having made a serious mistake. This paper describes common elements identified in how physicians coped positively with these difficult circumstances, and the positive ways in which they learned and changed.Physicians were recruited nationally through advertisement and word of mouth. Researchers conducted in-depth interviews with 61 physicians who had made a serious medical error. Verbatim transcripts were analyzed using a grounded theory approach and constant comparative analysis methodology.Our analysis identified five major elements in the process of coping positively with the experience of a serious medical error. These elements included acceptance, stepping in, integration, new narrative and wisdom. Subthemes further detail the content within each element.This study provides evidence that the experience of coping with a serious mistake can be formative in a positive way for physicians and provides a “roadmap” for growth through this experience.The profession must now seek ways to foster the development of wisdom out of these difficult experiences.