title: The attitudes and experiences of trainees regarding disclosing medical errors to patients.
abstract: OBJECTIVE
  To measure trainees' attitudes and experiences regarding medical error and error disclosure.
  
  
  METHODS
  In 2003, the authors carried out a cross-sectional survey of 629 medical students (320 in their second year, 309 in their fourth year), 226 interns (159 in medicine, 67 in surgery), and 283 residents (211 in medicine, 72 in surgery), a total 1,138 trainees at two U.S. academic health centers.
  
  
  RESULTS
  The response rate was 78% (889/1,138). Most trainees (74%; 652/881) agreed that medical error is among the most serious health care problems. Nearly all (99%; 875/884) agreed serious errors should be disclosed to patients, but 87% (774/889) acknowledged at least one possible barrier, including thinking that the patient would not understand the disclosure (59%; 525/889), the patient would not want to know about the error (42%; 376/889), and the patient might sue (33%; 297/889). Personal involvement with medical errors was common among the fourth-year students (78%; 164/209) and the residents (98%; 182/185). Among residents, 45% (83/185) reported involvement in a serious error, 34% (62/183) reported experience disclosing a serious error, and 63% (115/183) had disclosed a minor error. Whereas only 33% (289/880) of trainees had received training in error disclosure, 92% (808/881) expressed interest in such training, particularly at the time of disclosure.
  
  
  CONCLUSIONS
  Although many trainees had disclosed errors to patients, only a minority had been formally prepared to do so. Formal disclosure curricula, coupled with supervised practice, are necessary to prepare trainees to independently disclose errors to patients by the end of their training.
authors.affiliation: Department of Medicine, University of Washington School of Medicine, Seattle, Washington 98105-4608, USA.
authors.forename: Andrew A
authors.initials: AA
authors.lastname: White
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Gallagher
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Krauss
authors.forename: Jane
authors.initials: J
authors.lastname: Garbutt
authors.forename: Amy D
authors.initials: AD
authors.lastname: Waterman
authors.forename: W Claiborne
authors.initials: WC
authors.lastname: Dunagan
authors.forename: Victoria J
authors.initials: VJ
authors.lastname: Fraser
authors.forename: Wendy
authors.initials: W
authors.lastname: Levinson
authors.forename: Eric B
authors.initials: EB
authors.lastname: Larson
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D003430:Cross-Sectional Studies; D003625:Data Collection; D004503:Education, Medical, Graduate; D004504:Education, Medical, Undergraduate; D004992:Ethics, Medical; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D010865:Pilot Projects; D013337:Students, Medical; D011795:Surveys and Questionnaires; D035502:Trust; D014342:Truth Disclosure