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Cited by 565Patient Safety and Medication ErrorsClinical Reasoning and Diagnostic SkillsInnovations in Medical Education

The DOI matches its Crossref record; 26 of the 26 references it cites were found in a registry or an index.

Do House Officers Learn From Their Mistakes?

Wu, Albert W.·1991·JAMA: The Journal of the American Medical Association
DOI 10.1001/jama.1991.03460160067031
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Abstract

Mistakes are inevitable in medicine. To learn how medical mistakes relate to subsequent changes in practice, we surveyed 254 internal medicine house officers. One hundred fourteen house officers (45%) completed an anonymous questionnaire describing their most significant mistake and their response to it. Mistakes included errors in diagnosis (33%), prescribing (29%), evaluation (21%), and communication (5%) and procedural complications (11%). Patients had serious adverse outcomes in 90% of the cases, including death in 31% of cases. Only 54% of house officers discussed the mistake with their attending physicians, and only 24% told the patients or families. House officers who accepted responsibility for the mistake and discussed it were more likely to report constructive changes in practice. Residents were less likely to make constructive changes if they attributed the mistake to job overload. They were more likely to report defensive changes if they felt the institution was judgmental. Decreasing the work load and closer supervision may help prevent mistakes. To promote learning, faculty should encourage house officers to accept responsibility and to discuss their mistakes.

Overview

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Crossref · 10.1001/jama.1991.03460160067031

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Metadata

Authors
Wu, A. W.
Affiliations
University of California, San Francisco (US)
Corresponding author
Wu, Albert W.
ORCID
Wu, Albert W.
Venue
JAMA: The Journal of the American Medical Association
Publisher
American Medical Association (AMA)
Published
1991-04-24
Volume
265
Issue
16
Pages
2089
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.1991.03460160067031
OpenAlex
W2150756606
Cited by
565
References
26
Citations by year
2026: 4 · 2025: 5 · 2024: 3 · 2023: 13 · 2022: 13 · 2021: 12 · 2020: 14 · 2019: 13 · 2018: 14 · 2017: 18 · 2016: 13 · 2015: 9 · 2014: 23 · 2013: 25 · 2012: 32
FWCI
19.64
Type
journal article
Language
en
Open access
closed
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Mental Health (MH 42459, P50MH042459)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Patient Safety and Medication Errors
  • Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
  • Social Sciences › Education › Innovations in Medical Education
Keywords
medical errors, learning from mistakes, medical residents, internal medicine residents, error reporting, patient disclosure, acceptance of responsibility, work overload, workload, supervision, adverse clinical outcomes, diagnostic errors, prescribing errors
MeSH terms
Analysis of Variance, Clinical Competence, Decision Making, Diagnostic Errors, Hospitals, Teaching, Humans, Internal Medicine, Internship and Residency, Learning, Practice Patterns, Physicians', Drug Prescriptions, Surveys and Questionnaires, Disclosure

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