RP401 – Session 2.2: Mistakes



Session Readings

 

Background

We have often heard the phrase “everyone makes mistakes.” While this is readily accepted as fact in many fields of work, it is much less readily accepted by healthcare professionals, perhaps due to the fact that mistakes in healthcare can have profound consequences. Coping with our own mistakes, especially when those mistakes result in poor outcomes can be particularly difficult in the obstetric realm.  At the same time, it is important to recognize that our reactions to mistakes in healthcare can be quite powerful, even when there is no bearing on the patient’s outcome. Feelings of guilt and shame often pervade the experience, influencing us in myriad ways that can all have an impact on the way we treat our patients.

During the small group discussion, we will explore:

  • Our reactions to mistakes we have made and those we have observed
  • The sources of these reactions (our personal contexts)
  • How these reactions impacted the way we cared for our patients and their family in that situation, and how it may impact the way we care for patients in the future.

Prior to the session, in addition to considering how you have reacted to your own mistakes in the past, We challenge you to also consider your past reactions to the mistakes of others. You will see that we have included Emily Pronin’s article “How We See Ourselves and How We See Others” as one of the supplemental resources for this session. The article does a phenomenal job describing that while we are able to reflect on and identify our own motivations, we are at best able to identify our perception of others’ motivations. This understanding is critical in any discussion of mistakes in healthcare. I implore you to read it before the session as I am convinced that it will facilitate your introspection during this session.


Assignment:

Prior to the small group, reflect on a situation in which you made a medical mistake.  Come to the small group with notes that will help you to:

  • set the stage for the encounter
  • identify how you reacted to the mistake you made, how you perceived others to react, and what you did in response to the mistake and your reactions to the mistake
  • explore whether your experienced feelings of guilt or shame and if so, how you coped with them
  • how the mistake impacted you on a personal level, and also how it impacted the care you delivered in the weeks that followed.

Objectives:

By the end of this session of Reflective Practice, residents, through small group discussion, will demonstrate the ability to:

  • reflect on mistakes they have made during their medical careers
  • identify their reactions to those mistakes and the sources of those reactions
  • explore how those reactions impacted the care they delivered
  • analyze strategies for coping with mistakes in the future.
TEDxTransparency, Compassion, and Truth in Medical Errors Leilani Schweitzer's son died by fault of medical error - she talks of the importance of transparency, truth, and compassion in medicine.
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Washington-PostMedical errors are hard for doctors to admit, but it’s wise to apologize to patients by Manoj Jain Apologizing for medical mistakes may be more than just a matter of conscience.
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New York TimesThe Many Errors in Thinking About Mistakes by Alina Tugend Children learn that ‘everyone makes mistakes’ as a crucial part of the learning process, but are rewarded for getting the right answer. A NY Times columnist explores society’s paradoxical approach to making mistakes.
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TEDxBrian Goldman: Doctors make mistakes. Can we talk about that? What’s an acceptable “batting average” for a physician? Brian Goldman examines the paradox of perfection in medicine, starting with three little words all physicians dread.
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Button PoetryDeceit & I RJ Walker performs this emotion-provoking poem about the large role that deceit undeniably plays in our lives and careers as a tool to save others from pain.
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downloadHow We See Ourselves, How We See Others by Emily Pronin Does our ability to know our own volition give us accurate insight into the volition of others? This article argues that the answer is a definitive "No".
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Session originally created by: Adam Saperstein | SOM/GSN, Uniformed Services University | Director, Reflective Practice | Family Medicine