Advertisement

Pediatric Resident Education About Medical Errors

  • Kathleen E. Walsh
    Correspondence
    Address correspondence to Kathleen E. Walsh, MD, Maternity Building, Room 4104, Boston Medical Center, 91 East Concord St, Boston, MA 02118
    Affiliations
    Search for articles by this author
  • Marlene R. Miller
    Affiliations
    From the Department of Pediatrics, Boston University School of Medicine/Boston Medical Center (Drs Walsh, Vinci, Bauchner), Boston, Mass; the Agency for Healthcare Research and Quality (Drs Miller, Bauchner), National Institutes of Health, Bethesda, Md; Department of Pediatrics (Dr Miller), Johns Hopkins University, Baltimore, Md
    Search for articles by this author
  • Robert J. Vinci
    Affiliations
    From the Department of Pediatrics, Boston University School of Medicine/Boston Medical Center (Drs Walsh, Vinci, Bauchner), Boston, Mass; the Agency for Healthcare Research and Quality (Drs Miller, Bauchner), National Institutes of Health, Bethesda, Md; Department of Pediatrics (Dr Miller), Johns Hopkins University, Baltimore, Md
    Search for articles by this author
  • Howard Bauchner
    Affiliations
    From the Department of Pediatrics, Boston University School of Medicine/Boston Medical Center (Drs Walsh, Vinci, Bauchner), Boston, Mass; the Agency for Healthcare Research and Quality (Drs Miller, Bauchner), National Institutes of Health, Bethesda, Md; Department of Pediatrics (Dr Miller), Johns Hopkins University, Baltimore, Md
    Search for articles by this author
      Background.—National organizations have called for patient safety curricula to help reduce the incidence of errors. Little is known about what trainees are taught about medical errors.
      Objective.—1) To determine the amount and type of training that pediatric residents have about medical errors and 2) to assess pediatric chief resident knowledge about medical errors.
      Methods.—We surveyed chief residents from a national sample of 51 pediatric training programs by selecting every fourth program from the American Council on Graduate Medical Education list of accredited programs. The 21-item telephone survey was developed with patient safety specialists and piloted on several chief residents. It asked about patient-safety training sessions and awareness and knowledge about medical errors.
      Results.—The 51 chief residents helped teach 2176 residents, approximately one third of all pediatric residents. One third of programs had no lectures about medical errors and 23% did not have morbidity and mortality rounds. Sixty-one percent of respondents stated that outpatient medical errors were rarely discussed. Informal teaching was most often reported as the primary method for educating residents about medical errors. Although 58% of respondents did not know that a systemic change should be made in response to a medical error, 83% felt that residents are adequately trained to deal with a medical error.
      Discussion.—Pediatric resident education about medical errors varies widely. Attention by pediatric residency training programs to this important issue seems limited.

      KEY WORDS

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Academic Pediatrics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      REFERENCES

        • Institute of Medicine.
        To Err Is Human: Building a Safer Health System. National Academy Press, Washington, DC2000
        • Kaushal R
        • Bates DW
        • Landrigan C
        • et al.
        Medication errors and adverse drug events in pediatrics inpatients.
        JAMA. 2001; 285: 2114-2120
        • Quality Interagency Coordination Task Force.
        Doing What Counts for Patient Safety: Federal Actions to Reduce Medical Errors and Their Impact. The Quality Interagency Coordination Task Force, Washington, DC2000: 87
        • American Academy of Pediatrics.
        Principles of patient safety in pediatrics.
        Pediatrics. 2001; 107: 1473-1475
        • ACGME Outcome Project.
        (Accessed April 12, 2004)
        • Institute of Medicine.
        Crossing the Quality Chasm: A New Health System for the 21st Century. National Academy Press, Washington, DC2001
        • Kozer E
        • Scolnik D
        • Macpherson A
        • et al.
        Variables associated with medication errors in pediatric emergency medicine.
        Pediatrics. 2002; 110: 737-742
        • Rowe C
        • Koren T
        • Koren G
        Errors by paediatric residents in calculating drug doses.
        Arch Dis Child. 1998; 79: 56-58
        • Potts M
        • Phelan K
        Deficiencies in calculation and applied mathematics skills in pediatrics among primary care interns.
        Arch Pediatr Adolesc Med. 1996; 150: 748-752
        • Watson PD
        • Hammel M
        • Martin R
        Prescription-writing by pediatric house officers.
        J Med Educ. 1981; 56: 423-428
        • Cosby K
        • Croskerry P
        Patient safety: a curriculum for teaching patient safety in emergency medicine.
        Acad Emerg Med. 2003; 10: 69-78
        • Gosbee J
        A patient safety curriculum for residents and students: the VA healthcare systems pilot project.
        ACGME Bull. 2002; (Accessed August 10, 2003)
        • Wu AW
        • Folkman S
        • McPhee SJ
        • Lo B
        Do house officers learn from their mistakes?.
        JAMA. 1991; 265: 2089-2094
        • Committee on Medical Student Education in Pediatrics General Pediatric Clerkship Curriculum.
        (Accessed September 6, 2003)
        • American Academy of Pediatrics.
        The future of pediatric education II: organizing pediatric education to meet the needs of infants, children, adolescents, and young adults in the 21st century.
        Pediatrics. 2000; 105: 163-212
        • Ambulatory Pediatric Association.
        Educational guidelines for residency training in general pediatrics.
        (Accessed September 5 and 11, 2004)
        • Nelson L
        • Gordon P
        • Simmons M
        • et al.
        The benefit of house officer education on proper medication dose and calculation ordering.
        Acad Emerg Med. 2000; 7: 1311-1315
        • Peterson LA
        • Brennan TA
        • O'Neill AC
        • et al.
        Does housestaff discontinuity of care increase the risk for preventable adverse events?.
        Ann Intern Med. 1994; 121: 866-872