Physicians continually strive to prevent medical errors, but they still happen. When a serious medical error occurs, physicians must learn to accept them and use the error to grow professionally, despite the challenging nature of such experiences.
A recent study in Academic Medicine found that although "healthcare institutions are increasingly recognizing the physician as the 'second victim' of medical error, more attention needs to be placed on reframing the error into a positive post-learning event, rather than a 'coping' or 'surviving' framework."
To understand what helps physicians manage distress and find support after making harmful errors, professors at the University of Virginia School of Medicine in Charlottesville, the University of Florida in Gainesville and Harvard Medical School in Boston spent three years interviewing 61 experienced physicians who volunteered to discuss their most serious self-reported medical errors.
Here are seven steps that helped the interviewed physicians learn and heal after committing a medical error, according to the study.
1. Talking about the medical error. The majority of the physician respondents said "being able to talk about it" helped them the most.
"[M]ost felt that having someone who could understand the experience from a clinical context was helpful," the study authors wrote. Physicians also said speaking with colleagues who didn't attempt to minimize the seriousness of the error or dismiss its associated emotions was important.
2. Forgiving oneself. Some physicians make the decision to explicitly forgive themselves, a process that requires self-acceptance and self-awareness, according to the report.
3. Having a strong moral context to encourage themselves to do the right thing. Physicians indicated having moral standards in place — including a professional code of conduct, spiritual teachings or a strong sense of humanism — helped them see the right thing to do after committing the medical error, according to the study. Some discussed important values with their mentors.
4. Learning to accept imperfection. Physicians are often burdened by an unrealistic question for perfection. For many physicians who committed serious medical errors, admitting vulnerability to their peers helped. "By talking with colleagues, they began to realize that other very good doctors had made mistakes too, which gave them permission to change their perfectionist understanding of themselves," the study authors wrote.
5. Gaining expertise on whatever caused the mistake. For many physicians, committing a medical error drove them to "become an expert in whatever they felt was the knowledge or technical deficiency that caused the error," according to the study. To accomplish this, some physicians made career changes, while others mastered new topics or techniques related to their previous medical error.
6. Enhancing teamwork. Several physicians said they decided to closely analyze their errors to understand how to avoid them in the future, while emphasizing the importance of teamwork to address and prevent errors.
7. Teaching others how to prevent the same error. There was an average of eight years between the time the medical error was committed and the time of the interviews for this study, which shows the process of "recovery and growth in the wake of a medical error" requires time. In addition to talking about their errors, many of the physicians interviewed said they decided to help teach others how to prevent the errors they made from occurring again.