“Hey, Remember that Patient?” How to HEEAL: A Medical Error Disclosure Curriculum (1090-003493) (Developmental Research Projects: Communication, Debriefing, Faculty Training (By Invitation Only))
Start time: Thursday, February 4, 2021 End time: Thursday, February 4, 2021, 3:00 PM Session Type: Research Study Development and Presentation Program Abstracts
Medical errors have been cited as the third leading cause of death in the US. The Joint Commission has stated that patients must remained informed on unanticipated outcomes of care. However, studies suggest only about one-third of errors are disclosed, and to inconsistent depth. There is no current standardized method for disclosing medical errors. Additionally, healthcare providers are often the ones to catch other colleagues’ medical errors but are unequipped to have productive conversations when the situation arises. Medical errors have deep personal, emotional, and professional consequences, yet the approach to disclosing medical errors to colleagues is often overlooked in training. In this study, we sought to determine if it is possible to design an effective simulation curriculum for medical error disclosure, not only to patients and their families, but also to colleagues.
Fourth-year medical students rotating within Indiana University are eligible for participation in this study. The 6-hour curriculum is divided into two sessions: (1) patient/family medical error disclosure, and (2) disclosure of a discovered error to the responsible colleague. Students will complete a competency survey, multiple choice test, and summative “baseline” simulation with a standardized patient (SP). Faculty then will host a brief lecture on a mnemonic for the aspects of a complete error disclosure, HEEAL: Honesty, Empathy, Education, Apology (patient) or Awareness (colleague), and Lessen Chance for Future Events. Following this, students will practice using this mnemonic in a formative simulation using a rapid cycle deliberate practice (RCDP) format with an SP in the role of a family member or colleague. Each session will conclude with a second summative simulation. At the end of the day, students will again complete the multiple-choice test and competence survey.
This study evaluates skills, knowledge, and attitude. Our skills component consists of a standardized checklist of actions that should occur during medical error disclosure. This will be completed by trained SPs after the students’ summative simulations (pre- and post-intervention). Knowledge changes will be measured by a multiple-choice questionnaire pre- and post- intervention. This questionnaire was designed specifically for this curriculum and has undergone review by both content experts and volunteers at the same educational level as our anticipated participants. Attitude will be assessed by a previously-validated questionnaire, the BEDA tool, pre- and post- intervention. We have added an additional five questions to the end of the BEDA tool to further understand the backgrounds our participants have in peer-peer disclosure, as there is limited literature on this specific topic. Data will be analyzed by our on-site psychometrician and reviewed by key person.