Residents' responses to medical error: coping, learning, and change.
OBJECTIVE
To explore the significant emotional challenges facing resident physicians in the setting of medical mishaps, as well as their approaches to coping with these difficult experiences.


METHODS
Twenty-six resident physicians were randomly selected from a single teaching hospital and participated in in-depth qualitative interviews. Transcripts were analyzed iteratively and themes identified.


RESULTS
Residents expressed intense emotional responses to error events. Poor patient outcomes and greater perceived personal responsibility were associated with more intense reactions and greater personal anguish. For the great majority of residents, their ability to cope with these events was dependent on a combination of reassurance and opportunities for learning. Interactions with medical colleagues and supervisory physicians were critical to this coping process.


CONCLUSIONS
Medical mishaps have a profound impact on resident physicians by eliciting intense emotional responses. It is critical that resident training programs recognize the personal and professional significance of these experiences for young physicians. Moreover, resident education must support the development of constructive coping skills by facilitating candid discussion and learning subsequent to these events.
Engel
Kirsten G
KG
Section of Emergency Medicine, Yale University, 464 Congress Ave., Suite 260, New Haven, CT 06519, USA. kirsten.engel@yale.edu
Rosenthal
Marilynn
M
Sutcliffe
Kathleen M
KM
D000223:Adaptation, Psychological; D000328:Adult; D004644:Emotions; D005260:Female; D006801:Humans; D007396:Internship and Residency; D007398:Interpersonal Relations; D007407:Interviews as Topic; D007858:Learning; D008297:Male; D019300:Medical Errors / Q000523:psychology*; D012944:Social Support; D014481:United States