Hughes Kate E, Cahir Thomas M, Nordlund Diana, Keim Samuel M, Hughes Patrick G
Department of Emergency Medicine, University of Arizona College of Medicine, Tucson, AZ, USA.
University of Arizona Health Sciences, Tucson, AZ, USA.
J Med Educ Curric Dev. 2022 Apr 27;9:23821205221096269. doi: 10.1177/23821205221096269. eCollection 2022 Jan-Dec.
Medical malpractice payouts across specialties totaled over $4.03 billion USD in 2019. It is estimated that over 72% of Emergency Medicine (EM) physicians will be involved in a medical malpractice lawsuit by age 55. The majority of EM residencies do not include adequate education on medicolegal risk mitigation and litigation. The purpose of the study is implementation of an innovative interprofessional simulation to target this education gap.
An anonymous pre- and post-survey was distributed to participating EM providers electronically. The surveys evaluated baseline medicolegal knowledge, self-rated deposition comfort and concern regarding malpractice litigation. The simulation event involved an interactive lecture on basic tenets of medical malpractice and state legal statutes from medicolegal experts. Resident physician volunteers acted as defendant physicians during simulated depositions using a redacted, closed malpractice case.
Eighty EM providers attended the event over two days. All attendees completed the pre-survey (80/80), and 66.3% (53/80) completed the post-survey. The majority incorrectly answered 4 of 5 medicolegal questions. The mean comfort level regarding being deposed is 1.53 ± 0.94 on a 1-5 Likert scale (extremely uncomfortable to extremely comfortable); the mean level of concern/fear of malpractice litigation is 3.38 ± 0.95 on a 1-5 Likert scale (not at all to extremely concerned). There was a statistically significant increase in deposition comfort level post-event (1.83, < .01).
The majority of EM physicians are inexperienced and concerned regarding litigation. After participating in an educational event and observing a simulated deposition, physicians reported an increased comfort level regarding being deposed in the future.
2019年各专业医疗事故赔偿总额超过40.3亿美元。据估计，超过72%的急诊医学（EM）医生在55岁时将卷入医疗事故诉讼。大多数急诊医学住院医师培训项目没有提供足够的关于降低法医学风险和诉讼的教育。本研究的目的是实施一种创新的跨专业模拟，以弥补这一教育差距。
通过电子方式向参与的急诊医学提供者分发匿名的课前和课后调查问卷。这些调查评估了基线法医学知识、自我评估的证词舒适度以及对医疗事故诉讼的担忧。模拟活动包括由法医学专家进行的关于医疗事故基本原则和州法律法规的互动讲座。住院医师志愿者在使用经过编辑的封闭医疗事故案例进行模拟证词时扮演被告医生。
80名急诊医学提供者在两天内参加了该活动。所有参与者都完成了课前调查（80/80），66.3%（53/80）完成了课后调查。大多数人在5道法医学问题中答错了4道。在1-5李克特量表（从极度不舒服到极度舒服）上，被询问证词时的平均舒适度为1.53±0.94；在1-5李克特量表（从完全不担心到极度担心）上，对医疗事故诉讼的平均担忧/恐惧程度为3.38±0.95。活动后，证词舒适度有统计学上的显著提高（1.83，<0.01）。
大多数急诊医学医生在诉讼方面缺乏经验且感到担忧。在参加了一次教育活动并观察了模拟证词后，医生们报告说未来面对被询问证词时的舒适度有所提高。
