Christensen J F, Levinson W, Dunn P M
Department of Medicine, Good Samaritan Hospital, Portland, OR 97210.
J Gen Intern Med. 1992 Jul-Aug;7(4):424-31. doi: 10.1007/BF02599161.
To describe how physicians think and feel about their perceived mistakes, to examine how physicians' prior beliefs and manners of coping with mistakes may influence their emotional responses, and to promote further discussion in the medical community about this sensitive issue.
Audiotaped, in-depth interviews with physicians in which each physician discussed a previous mistake and its impact on his or her life. Transcripts of the interviews were analyzed qualitatively and the data organized into five topic areas: the nature of the mistake, the physician's beliefs about the mistake, the emotions experienced in the aftermath of the mistake, the physician's way of coping with the mistake, and changes in the physician's practice as a result of the mistake.
Eleven general internists and medical subspecialists practicing at a community, university-affiliated hospital in Oregon.
Themes emerging from analysis of the interviews were the ubiquity of mistakes in clinical practice; the infrequency of self-disclosure about mistakes to colleagues, family, and friends; the lack of support among colleagues; the degree of emotional impact on the physician, so that some mistakes were remembered in great detail even after several years; and the influence of the physician's professional locus of control on subsequent emotions.
The perception of having made a mistake creates significant emotional distress for practicing physicians. The severity of this distress may be influenced by factors such as prior beliefs and perfectionism. The extent to which physicians share this distress with colleagues may be influenced by the degree of competitiveness engendered by medical training. Open discussion of mistakes should be more prominent in medical training and practice, and there should be continued research on this topic.
描述医生对自己所认为的错误的思考和感受，研究医生先前的信念以及应对错误的方式如何影响他们的情绪反应，并推动医学界就这一敏感问题展开进一步讨论。
对医生进行录音的深度访谈，每位医生讨论一个先前的错误及其对自己生活的影响。对访谈记录进行定性分析，并将数据整理为五个主题领域：错误的性质、医生对错误的信念、错误发生后的情绪体验、医生应对错误的方式以及错误导致的医生行医方式的改变。
俄勒冈州一家社区大学附属医院的11名普通内科医生和医学专科医生。
访谈分析得出的主题包括临床实践中错误普遍存在；向同事、家人和朋友自我披露错误的情况很少见；同事之间缺乏支持；对医生的情绪影响程度，以至于有些错误即使在几年后仍被详细铭记；以及医生的职业控制点对后续情绪的影响。
认为自己犯了错误会给执业医生带来巨大的情绪困扰。这种困扰的严重程度可能受到先前信念和完美主义等因素的影响。医生与同事分享这种困扰的程度可能受到医学培训所产生的竞争程度的影响。在医学培训和实践中，应更突出地开展关于错误的公开讨论，并且应对这一主题持续进行研究。
