Preparing Medical Students and Physicians to Cope With Their Medical Errors: A Scoping Review

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PURPOSE: Many clinicians will experience feeling responsible for inadvertently harming a patient through medical error. These situations can be distressing, difficult to navigate, and career altering. In addition to aftermath support, there is a recognized need for preemptive education to better prepare clinicians to cope after such events. Little published guidance exists about how best to do this. This scoping review explores the current knowledge about educational programs and strategies to prepare medical students and physicians to cope effectively with their own medical errors. METHOD: Three online databases, MEDLINE, PsycINFO, and Scopus, were searched on January 3, 2025, for articles published from database inception to the search date that described programs designed to prepare medical students and/or physicians to cope better with personal involvement in patient harm from medical error. Eligibility screening and data recording were independently performed by 2 reviewers. Simple data were summarized, and common pedagogical strategies were identified by inductive thematic analysis. RESULTS: The search yielded 5,359 unique articles for screening, of which 97 full-text articles were retrieved. Twelve articles met the eligibility criteria. The study interventions varied in structure and delivery methods but shared similar rationale, key messages, and pedagogical strategies. Dominant pedagogical strategies were divided into 2 groups: (1) what students need to learn about coping after medical error (attend to emotions, universality of fallibility, helpful and unhelpful paths for coping, workplace culture, care for colleagues, transfer of learning to the workplace) and (2) ways to support students in this learning (actual cases, psychological safety and honest conversation, role-modeling, reflection and learning from others' experience). CONCLUSIONS: A constellation of pedagogical strategies synthesized from the literature provides program design ideas for education that targets the development of learners' capacity to cope with involvement in patient harm from medical error.

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