Teaching error disclosure: Advanced communication skills training for residents

Abstract

Disclosing errors to patients is an advanced communication skill necessary in clinical practice but traditionally not taught during residency training. We developed an educational seminar for senior residents utilizing didactic, small group discussion, and role play that incorporates principles of error disclosure. Our objectives were to improve resident's knowledge of the key components of disclosing medical errors to patients and to provide opportunity to practice communicating medical error in a safe environment. We assessed whether residents are participating in error disclosure and compared self-rated preparedness to disclose an error before and after the teaching session. Nearly all residents (94%) reported that learning about disclosure of medical errors is a very important part of residency training and 58% of residents had already participated in a disclosure discussion. Residents reported they were significantly more prepared to disclose medical errors to patients after participating in the curriculum compared with before, both in terms of the components of medical error disclosure and the emotional aspects of disclosure. This curriculum was associated with improvement in comfort level with error disclosure. Error disclosure represents an ideal educational opportunity for residencies to address multiple core competencies including patient care, communication skills, and professionalism.

Keywords:

• Communication skills
• Error disclosure
• Graduate medical education
• Residency

Additional information

Notes on contributors

Rachel A Bonnema

Rachel A. Bonnema is Assistant Professor of Medicine in the Division of General Internal Medicine at the University of Nebraska Medical Center. She is an active clinician-educator for the internal medicine residency program, serving as associate program director, and the medical school. She has a general internal medicine and women's health outpatient practice. Her areas of research and educational work are in communication skills, curriculum development, and women's health.

Alda Maria R Gonzaga

Alda Maria R. Gonzaga is Assistant Professor of Internal Medicine in the Division of General Internal Medicine at the University of Pittsburgh School of Medicine in the Section of Women's Health. She is the director of a transitional care clinic for adult patients with disabilities and serves as the program director for the Medicine-Pediatrics Residency Program. Alda Maria is actively involved in resident education with a special interest in women's health, adolescent medicine, and communication skills.

James E Bost

James E. Bost is Associate Professor of Medicine, Clinical and Translational Science, and Biostatistics at the University of Pittsburgh School of Medicine. He works in the Center for Research on Health Care (CRHC) Data Center, which provides web design, database development, data management, and statistical analysis across the university and medical center. He primarily provides management and statistical support for large clinical trials and provides statistical and grant-writing support for investigators through the Clinical and Science Training Institute.

Carla L Spagnoletti

Carla L. Spagnoletti is Assistant Professor of Medicine in the Division of General Internal Medicine at the University of Pittsburgh School of Medicine in the Section of Women's Health. She has an active general internal medicine and women's health outpatient practice and also serves as a clinician-educator for the internal medicine residency program and the medical school. Her areas of research and education work are in patient–doctor communication skills training, women's health and the use of web-based curricula and programs to enhance medical education.