MedicalResearch.com Interview with:
Jason Han, MD
Resident, Cardiothoracic Surgery
Hospital at the University of Pennsylvania
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The inspiration for this study comes from my personal experience as a medical student on clinical rotations. Despite having been a victim of a medical error while growing up myself, I found it extraordinarily difficult to admit to even some of my smallest errors to my patients and team. Perplexed by the psychological barriers that impeded error disclosure, I began to discuss this subject with my advisory Dean and mentor, Dr. Neha Vapiwala. We wanted to analyze the topic more robustly through an academic lens and researched cognitive biases that must be overcome in order to facilitate effective disclosure of error, and began to think about potential ways to implement these strategies into the medical school curriculum with the help of the director of the Standardized Patient program at the Perelman School of Medicine, Denise LaMarra.
We ultimately contend that any educational strategy that aims to truly address and improve error disclosure must target the cognitive roots of this paradigm. And at this point in time, simulation-based learning seems to be the most direct way to do so, but also remain hopeful that emerging technologies such as virtual and augmented reality may offer ways for students as well as staff to rehearse difficult patient encounters and improve.
MedicalResearch.com: What should readers take away from your report?
Response: We believe that there are tremendous lessons to be gleaned from the field of social psychology for the betterment of patient care. For example, this manuscript describe two such biases — the Correspondence Bias, which is our tendency to attribute error to individuals instead of circumstances, and the Forecasting Error, which is our tendency to overestimate the negative consequences of something. These cognitive biases that play pivotal roles in error disclosure are well-described in the literature, but had not been directly applied to medical education previously. Once we understand these among other social psychology concepts in medicine, the potential improvement in our delivery of patient care from the collaboration of these two disciplines is limitless.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: This manuscript has exciting implications for the direction of future research in medical education. By identifying key cognitive biases and designing targeted simulation-based learning modules, students can begin to learn critical strategies in overcoming even the most difficult patient scenarios. In other words, analyzing the cognitive biases behind error disclosure gives educators the tools to directly and specifically buttress students’ cognitive resilience to prepare for these scenarios. Therefore, studying the longitudinal benefits of such interventions, either involving standardized patients or other simulation-based platforms would be a rewarding area of future research.
The intervention can also be top-down, as the leaders in medical education can help design and establish a national standard for assessing students’ interpersonal skills and ability to manage difficult patient scenarios. Currently, the Step 2 Clinical Skills test provides the minimal framework for assessing these elements. Notably, with improvements in its existing criteria, it has tremendous potential to evaluate and to provide a national benchmark for the humanistic, interpersonal and ethical aspects of patient care. This may provide a powerful impetus for changes in medical education across the country, offering an exciting topic for future research.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Jason Han, Denise LaMarra, Neha Vapiwala. Applying lessons from social psychology to transform the culture of error disclosure. Medical Education, 2017;
Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.
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