title: Teaching medical error disclosure to residents using patient-centered simulation training.
abstract: OBJECTIVE
  To determine whether a standardized patient encounter and self-guided tutorial would improve first-year residents' self-efficacy for disclosing medical errors.
  
  
  METHODS
  In 2011, 55 first-year residents participated in a simulation in which they disclosed an error to a standardized patient playing the part of a family member. Residents completed the simulation twice, four weeks apart, and completed presession knowledge and self-efficacy (based on the Accreditation Council for Graduate Medical Education [ACGME] core competencies) assessments and repeated the self-efficacy assessment after the sessions. Residents reviewed the videos of their encounters either alone (self-debrief) or with a faculty observer (faculty debrief). Between sessions, they completed a self-paced learning tutorial. Two external faculty also rated the residents' performances using videos of the encounters.
  
  
  RESULTS
  Residents' self-efficacy significantly increased from a Session 1 pretest mean (standard deviation) score of 119.6 (26.6) to a Session 2 posttest score of 150.3 (24.9) for all ACGME competencies (P < .001, Cohen's d = 1.19). The external reviewers' ratings provided additional, objective support for residents' improvement on questions assessing ACGME competencies (P = .001). Comparisons of the self-efficacy of residents in the self-debrief versus faculty debrief groups yielded no significant differences on any ACGME competencies.
  
  
  CONCLUSIONS
  Timely, explicit, and empathetic disclosure of medical errors to patients and family is essential to maintaining trust and is an important part of patient-centered medical care. This intervention easily could be replicated in other settings and is applicable to many members of the health care team, not just to residents.
authors.affiliation: Dr. Sukalich is director, Department of Medical Education, OhioHealth Riverside Methodist Hospital, Columbus, Ohio. Dr. Elliott is research specialist, Department of Medical Education, OhioHealth Riverside Methodist Hospital, Columbus, Ohio. Ms. Ruffner is simulation center manager, Center for Medical Education and Innovation (CME+I), OhioHealth Riverside Methodist Hospital, Columbus, Ohio.
authors.forename: Sara
authors.initials: S
authors.lastname: Sukalich
authors.forename: John O
authors.initials: JO
authors.lastname: Elliott
authors.forename: Gina
authors.initials: G
authors.lastname: Ruffner
mesh_terms: D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement; D004645:Empathy; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D008297:Male; D019300:Medical Errors; D009820:Ohio; D016544:Patient Simulation; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D014342:Truth Disclosure; D014741:Video Recording