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逆境中的智慧:从错误中学习和成长。

Wisdom through adversity: learning and growing in the wake of an error.

机构信息

University of Virginia, Charlottesville, VA, USA.

出版信息

Patient Educ Couns. 2013 May;91(2):236-42. doi: 10.1016/j.pec.2012.12.006. Epub 2013 Feb 8.

Abstract

OBJECTIVE

Medical errors are a nearly universal experience for physicians. An error that harms a patient is one of the most difficult experiences that physicians face. Difficult experiences can result in growth. This study investigates how physicians coped positively with having made a serious mistake. This paper describes common elements identified in how physicians coped positively with these difficult circumstances, and the positive ways in which they learned and changed.

METHODS

Physicians were recruited nationally through advertisement and word of mouth. Researchers conducted in-depth interviews with 61 physicians who had made a serious medical error. Verbatim transcripts were analyzed using a grounded theory approach and constant comparative analysis methodology.

RESULTS

Our analysis identified five major elements in the process of coping positively with the experience of a serious medical error. These elements included acceptance, stepping in, integration, new narrative and wisdom. Subthemes further detail the content within each element.

CONCLUSION

This study provides evidence that the experience of coping with a serious mistake can be formative in a positive way for physicians and provides a "roadmap" for growth through this experience.

PRACTICE IMPLICATIONS

The profession must now seek ways to foster the development of wisdom out of these difficult experiences.

摘要

目的

医疗差错是医生几乎普遍会经历的事情。对患者造成伤害的差错是医生最难以面对的经历之一。艰难的经历可能会带来成长。本研究调查了医生如何积极应对严重错误。本文描述了医生在积极应对这些困难情况下所共有的应对要素,以及他们学习和改变的积极方式。

方法

通过广告和口碑在全国范围内招募医生。研究人员对 61 名犯过严重医疗错误的医生进行了深入访谈。使用扎根理论方法和不断比较分析方法对逐字记录进行了分析。

结果

我们的分析确定了积极应对严重医疗错误经历过程中的五个主要要素。这些要素包括接受、介入、整合、新叙述和智慧。子主题进一步详细说明了每个要素中的内容。

结论

这项研究为医生提供了证据,证明应对严重错误的经历可以以积极的方式对他们产生塑造作用,并为通过这种经历成长提供了“路线图”。

实践意义

现在,这个行业必须寻求方法,从这些艰难的经历中培养出智慧。

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