TABLE 3.

Intellectual Responses

What Went Wrong	"I think, yeah, I don't think anything like that can happen without going through and rethinking about it … going back to the beginning, the indication for what we were doing, what the patient wanted, what the patient understood, making sure that we had all those questions answered with the patient as well as the risks and benefits. And then also when we offered the surgery … the option, so I think personally more so meaning just making sure that I rethink all the steps." (ID31) "Me personally, I always like to have a breakdown with the attending either soon after or within a day or two and be like, hey, what did I do? How could I improve from A, B, or C? Is, was this an issue that I did, or was this going to happen kind of regardless of what we did?" (ID22) "But definitely, I reflected on, I kind of break it down into, you know, was there anything preoperatively that we maybe could've done differently? Was there anything intraoperatively we could've done? Was there anything postoperatively? Is there anything I personally would do differently or lessons that I would take away from it?" (ID6)
Decision Making	"Like I made the decision to sign off of her, and as a result, she got sick and now she passed away from this, and therefore, it was like my responsibility." (ID16) "So I think after the fact, you know, just sitting there analyzing, okay, we obviously had this event intraoperatively, and that affected us, and there was an error in judgment and a technical error. And then afterwards, you know, they were compounded." (ID35) "It definitely plays a role in future decision making, because you're always going to have that in the back of your head of, hey, the last time you did this or that one time you did this, this went wrong." (ID22)
Commitment to Improvement	"And they, yeah, I mean, you remember those days, and you learn from mistakes." (ID28) "I guess I think in general with any bad outcome or, you know, devastating results, I think, especially if it's a complication from a surgery that we're involved in or a treatment plan, I think I personally, to some degree take it personally or, you know, really reflect on my role in the situation and what I or the team could have done better." (ID35) "I think as soon as you identify a postoperative complication, or, you know, as soon as you kind of sort out a course of action for the patient, there's always like a period of self-examination." (ID6) "Sometimes like you can like go over it a million times in a million different ways and like you’re just feeling like you could have caught it like a day early or something. But like there’s nothing inherently, whether it was a technical or a judgment call that you did that would have changed anything. Sometimes those are the hardest ones to like, oh, there’s nothing I could have done." (ID16)