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. 1993 Nov;159(5):565–569.

How house officers cope with their mistakes.

A W Wu 1, S Folkman 1, S J McPhee 1, B Lo 1
PMCID: PMC1022346  PMID: 8279153

Abstract

We examined how house officers coped with serious medical mistakes to gain insight into how medical educators should handle these situations. An anonymous questionnaire was mailed to 254 house officers in internal medicine asking them to describe their most important mistake and their response to it; 45% (N = 114) reported a mistake and completed the questionnaire. House officers experienced considerable emotional distress in response to their mistakes and used a variety of strategies to cope. In multivariate analysis, those who coped by accepting responsibility were more likely to make constructive changes in practice, but to experience more emotional distress. House officers who coped by escape-avoidance were more likely to report defensive changes in practice. For house officers who have made a mistake, we suggest that medical educators provide specific advice about preventing a recurrence of the mistake, provide emotional support, and help them understand that distress is an expected concomitant of learning from the experience.

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Selected References

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  1. Aldwin C. M., Revenson T. A. Does coping help? A reexamination of the relation between coping and mental health. J Pers Soc Psychol. 1987 Aug;53(2):337–348. doi: 10.1037//0022-3514.53.2.337. [DOI] [PubMed] [Google Scholar]
  2. Alexander D., Monk J. S., Jonas A. P. Occupational stress, personal strain, and coping among residents and faculty members. J Med Educ. 1985 Nov;60(11):830–839. doi: 10.1097/00001888-198511000-00002. [DOI] [PubMed] [Google Scholar]
  3. Butterfield P. S. The stress of residency. A review of the literature. Arch Intern Med. 1988 Jun;148(6):1428–1435. [PubMed] [Google Scholar]
  4. Charles S. C., Warnecke R. B., Nelson A., Pyskoty C. E. Appraisal of the event as a factor in coping with malpractice litigation. Behav Med. 1988 Winter;14(4):148–155. doi: 10.1080/08964289.1988.9935139. [DOI] [PubMed] [Google Scholar]
  5. Eisendrath S. J., Link N., Matthay M. Intensive care unit: how stressful for physicians? Crit Care Med. 1986 Feb;14(2):95–98. doi: 10.1097/00003246-198602000-00004. [DOI] [PubMed] [Google Scholar]
  6. Folkman S., Lazarus R. S. An analysis of coping in a middle-aged community sample. J Health Soc Behav. 1980 Sep;21(3):219–239. [PubMed] [Google Scholar]
  7. Folkman S., Lazarus R. S. Coping as a mediator of emotion. J Pers Soc Psychol. 1988 Mar;54(3):466–475. [PubMed] [Google Scholar]
  8. Folkman S., Lazarus R. S., Gruen R. J., DeLongis A. Appraisal, coping, health status, and psychological symptoms. J Pers Soc Psychol. 1986 Mar;50(3):571–579. doi: 10.1037//0022-3514.50.3.571. [DOI] [PubMed] [Google Scholar]
  9. Folkman S., Lazarus R. S. If it changes it must be a process: study of emotion and coping during three stages of a college examination. J Pers Soc Psychol. 1985 Jan;48(1):150–170. doi: 10.1037//0022-3514.48.1.150. [DOI] [PubMed] [Google Scholar]
  10. Levinson W., Dunn P. M. A piece of my mind. Coping with fallibility. JAMA. 1989 Apr 21;261(15):2252–2252. doi: 10.1001/jama.261.15.2252. [DOI] [PubMed] [Google Scholar]
  11. Linn L. S., Yager J., Cope D., Leake B. Health habits and coping behaviors among practicing physicians. West J Med. 1986 Apr;144(4):484–489. [PMC free article] [PubMed] [Google Scholar]
  12. Matthews D. A., Classen D. C., Willms J. L., Cotton J. P. A program to help interns cope with stresses in an internal medicine residency. J Med Educ. 1988 Jul;63(7):539–547. doi: 10.1097/00001888-198807000-00005. [DOI] [PubMed] [Google Scholar]
  13. May H. J., Revicki D. A., Jones J. G. Professional stress and the practicing family physician. South Med J. 1983 Oct;76(10):1273–1276. doi: 10.1097/00007611-198310000-00020. [DOI] [PubMed] [Google Scholar]
  14. McCall T. B. The impact of long working hours on resident physicians. N Engl J Med. 1988 Mar 24;318(12):775–778. doi: 10.1056/NEJM198803243181210. [DOI] [PubMed] [Google Scholar]
  15. McCue J. D. The distress of internship. Causes and prevention. N Engl J Med. 1985 Feb 14;312(7):449–452. doi: 10.1056/NEJM198502143120725. [DOI] [PubMed] [Google Scholar]
  16. McCue J. D. The effects of stress on physicians and their medical practice. N Engl J Med. 1982 Feb 25;306(8):458–463. doi: 10.1056/NEJM198202253060805. [DOI] [PubMed] [Google Scholar]
  17. Mermann A. C. Coping strategies of selected physicians. Perspect Biol Med. 1990 Winter;33(2):268–279. doi: 10.1353/pbm.1990.0006. [DOI] [PubMed] [Google Scholar]
  18. Orman M. C. Physician stress: is it inevitable? Mo Med. 1989 Jan;86(1):21–25. [PubMed] [Google Scholar]
  19. Quill T. E., Williamson P. R. Healthy approaches to physician stress. Arch Intern Med. 1990 Sep;150(9):1857–1861. [PubMed] [Google Scholar]
  20. Wu A. W., Folkman S., McPhee S. J., Lo B. Do house officers learn from their mistakes? JAMA. 1991 Apr 24;265(16):2089–2094. [PubMed] [Google Scholar]

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