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Original article
A mixed-methods examination of the nature and frequency of medical error among junior doctors
  1. Paul O'Connor1,
  2. Sinéad Lydon2,3,
  3. Orla Mongan2,3,
  4. Fergal Connolly4,
  5. Aoibheann Mcloughlin5,
  6. Lyle McVicker6,
  7. Dara Byrne2,3
  1. 1 Department of General Practice, National University of Ireland Galway, Galway, Ireland
  2. 2 School of Medicine, National University of Ireland Galway, Galway, Ireland
  3. 3 Irish Centre for Applied Patient Safety and Simulation, National University of Ireland Galway, Galway, Ireland
  4. 4 Department of Health Systems, University College Dublin, Dublin, Ireland
  5. 5 Department of Psychiatry, St James' Hospital, Dublin, Ireland
  6. 6 Medicine, Galway University Hospital, Galway, Ireland
  1. Correspondence to Paul O'Connor, Discipline of General Practice, NUI Galway, Galway H91 TK33, Ireland; paul.oconnor{at}nuigalway.ie

Abstract

Purpose of the study To examine junior doctors’ experience and perceptions of medical errors in which they had been involved.

Study design A mixed-methods design, consisting of an error survey and critical incident technique (CIT) interviews, was used. The survey asked doctors in the first year of postgraduate training in Ireland whether they had made a medical error that had ‘played on (their) mind’, and if so, to identify factors that had contributed to the error. The participants in the CIT interviews were asked to describe a medical error in which they had been involved.

Results A total of 201 out of 332 (60.5%) respondents to the survey reported making an error that ‘played on their mind’. 'Individual factors’ were the most commonly identified group of factors (188/201; 93.5%), with ‘high workload’ (145/201; 72.1%) the most commonly identified contributory factor. Of the 28 CIT interviews which met the criteria for analysis, ‘situational factors’ (team, staff, task characteristics, and service user factors) were the most commonly identified group of contributory factors (24/28; 85.7%). A total of eight of the interviews were judged by subject matter experts (n=8) to be of medium risk to patients, and 20 to be of high-risk to patients. A significantly larger proportion of high-risk scenarios were attributed to ‘local working conditions’ than the medium-risk scenarios.

Conclusions There is a need to prepare junior doctors to manage, and cope with, medical error and to ensure that healthcare professionals are adequately supported throughout their careers.

  • health & safety
  • organisation of health services
  • quality in health care

http://dx.doi.org/10.1136/postgradmedj-2018-135897

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    Footnotes

    • Twitter @sinead_lydon @poc_doctor @DrDaraByrne

    • Contributors POC, SL, and DB planned the study. OM, AM, LMV, FC and DB recruited participants for the questionnaire survey and interviews, and conducted the interviews. FC transcribed the interviews. POC and SL analysed the data. POC, SL and DB prepared to initial draft of the manuscript. OM, AM, LM and FC commented on the initial draft of the manuscript. All authors approved the final manuscript for submission.

    • Funding This research was partially supported by funding from the National Doctor Training and Planning, Health Services Executive, Republic of Ireland.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval Ethical approval was obtained from the five participating hospitals.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request.