“Disbelief and Sadness”: First Year Health Profession Students’ Perspectives on Medical Error

Tuesday, August 20, 2019, 9:45 am - 11:15 am
Hyatt Northstar Ballroom
Theme: Aligning Education and Practice for Workforce Transformation and Health System Change

The creation of effective interprofessional education requires strategic development of health profession training curricula. An understanding of attitudes and perceptions surrounding medical errors will inform the design of interventions and educational strategies most suitable for healthcare providers.

The purpose of this study was to describe the reactions of first-year health profession students to a real-life medical error scenario using a unique approach reflecting on a video describing medical errors. We hypothesized that we would detect differences in reactions between disciplines. Following a video describing two separate medical errors, students from anesthesia assistant, medical imaging, medicine, nursing, physical therapy, and physician assistant programs provided open textbox responses reflecting on initial impressions of medical errors depicted in the video.

Student responses were assessed via inductive coding techniques and thematic analysis and stratified by discipline. Frequencies of key themes were calculated. Descriptive analyses characterized respondents and Chi-square tests compared responses between disciplines. A review of 373 student responses (79% response rate) indicated prevalence of four general domains, each containing two or more sub-themes. General domains included (1) emotional response (dyad sub-themes of positive vs. negative, n=255 [68.4%]); (2) assigning blame (sub-themes reflecting blame of individual providers, to the healthcare team or system, n=227 [60.1%]); (3) the relationship of context to medical errors (cause and effect, avoidable/preventable, patient/provider relationship, n=229 [61.4%]); and (4) proposal of solutions (increased accountability, increased training, improvement of leadership, improvement of systems, implementation of patient-centered care principles, n=253 [67.8%]).

First-year health professional students responded to medical error with strong emotion and distress. Their responses largely represent an individualistic view of healthcare in both the reasons behind and solutions to medical errors. No differences in response themes were observed by discipline, indicating an opportunity for interprofessional education in systems-level approaches to improve patient safety.

The data we obtained through this qualitative study speaks to the student’s attitudes and perceptions to medical error. Assessment of learners’ perceptions of patient safety and medical errors will help curriculum designers identify areas for improvement in student training programs and is a crucial first step in teaching practices that promote the reduction of adverse events.