مقاله انگلیسی رایگان در مورد مجهز کردن رزیدنت های پزشکی اورژانس – NCBI 2018

Emergency medicine (EM) is a high-risk clinical learning environment with reported rates of medical errors between 18% 1 to 32%.2 Unique challenges such as frequent interruptions, multiple transitions of care, time constraints, simultaneous management of multiple complex patients, decisions based on incomplete information, unfamiliar physician-patient relationship, and a lack of privacy increase the risk of medical errors and create barriers to effective identification and disclosure when errors occur. The ability to effectively disclose medical errors (DME) is crucial in EM. The 2010 American College of Emergency Physicians Policy Statement on Disclosure of Medical Errors 5 directs emergency physicians who determine an error has occurred to provide timely information about the error and its consequences to patients and their families. Despite this mandate, a disclosure gap exists in EM. When surveyed, 88% of emergency department (ED) patients in one academic setting desired full disclosure of the error and 63% of patients endorsed teaching physicians error disclosure techniques, honesty, and compassion as educational priorities.6 However, a survey of 55 EM residents from two programs demonstrated infrequent, inadequate disclosure to patients and families, occurring in only 28% of cases.7 To close the disclosure gap, the Accreditation Council for Graduate Medical Education (ACGME) has called for improved education surrounding DME during residency training. The ACGME Clinical Learning Environment Review (CLER) Pathways to Excellence 8 calls for “hands-on training” of DME, and the 2017 EM program requirements 9 state “residents must receive training in how to disclose adverse events to patients and families [and] should have the opportunity to participate in the disclosure of patient safety events, real or simulated” as a necessary educational component of the Clinical Learning and Working Environment.