Do house officers learn from their mistakes?

Abstract

Mistakes are inevitable in medicine. To learn how medical mistakes\nrelate to subsequent changes in practice, we surveyed 254 internal medicine\nhouse officers. One hundred fourteen house officers (45%) completed an\nanonymous questionnaire describing their most significant mistake and their\nresponse to it. Mistakes included errors in diagnosis (33%), prescribing\n(29%), evaluation (21%), and communication (5%), and procedural complications\n(11%). Patients had serious adverse outcomes in 90% of the cases, including\ndeath in 31% of cases. Only 54% of house officers discussed the mistake with\ntheir attending physicians, and only 24% told the patients or families. House\nofficers who accepted responsibility for the mistake and discussed it were\nmore likely to report constructive changes in practice. Residents were less\nlikely to make constructive changes if they attributed the mistake to job\noverload. They were more likely to report defensive changes....