Education program on medical error disclosure for emergency medicine residents using standardized patients

Abstract

Purpose: We aimed to develop a program for error disclosure for emergency medicine (EM) residents to determine its effects. Methods: Fifteen EM residents participated in 2020. The program included two-error disclosure sessions using standardized patients (SPs), a didactic lecture, and debriefing. The Kirkpatrick model was used to evaluate this program. Satisfaction scores and narrative reactions were collected (level 1). Residents were asked to choose their actions and explain reasons for the representative error cases before and after the program (level 2). After 2 months, they were asked to write their experiences of disclosing errors to real patients (level 3). The differences in the disclosing communication scores allocated by the SPs were compared between the senior and junior residents. Results: The residents' satisfaction scores were high. Before the program, some residents chose not to disclose errors when there were no harmful sequelae at the time of the incident. After the program, opinions changed, and the residents thought that all errors should be disclosed. Before the program, most residents disclosed the errors to patients first; after the program, they would report to the hospital first to receive guidance. After 2 months, five residents reported disclosing errors to real patients. The senior residents' total scores and the scores for "prevention of future errors"were higher. Conclusion: The residents showed confidence in error disclosure while maintaining rapport with the real patient, and some were satisfied with their disclosure approach. Our error disclosure program for EM residents had a positive effect on their behavior and attitude toward error disclosure.