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Female residents experiencing medical errors in general internal medicine: a qualitative study.

机译:在普通内科医学方面遇到医疗错误的女性居民:定性研究。

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摘要

BACKGROUND: Doctors, especially doctors-in-training such as residents, make errors. They have to face the consequences even though today's approach to errors emphasizes systemic factors. Doctors' individual characteristics play a role in how medical errors are experienced and dealt with. The role of gender has previously been examined in a few quantitative studies that have yielded conflicting results. In the present study, we sought to qualitatively explore the experience of female residents with respect to medical errors. In particular, we explored the coping mechanisms displayed after an error. This study took place in the internal medicine department of a Swiss university hospital.METHODS: Within a phenomenological framework, semi-structured interviews were conducted with eight female residents in general internal medicine. All interviews were audiotaped, fully transcribed, and thereafter analyzed.RESULTS: Seven main themes emerged from the interviews: (1) A perception that there is an insufficient culture of safety and error; (2) The perceived main causes of errors, which included fatigue, work overload, inadequate level of competences in relation to assigned tasks, and dysfunctional communication; (3) Negative feelings in response to errors, which included different forms of psychological distress; (4) Variable attitudes of the hierarchy toward residents involved in an error; (5) Talking about the error, as the core coping mechanism; (6) Defensive and constructive attitudes toward one's own errors; and (7) Gender-specific experiences in relation to errors. Such experiences consisted in (a) perceptions that male residents were more confident and therefore less affected by errors than their female counterparts and (b) perceptions that sexist attitudes among male supervisors can occur and worsen an already painful experience.CONCLUSIONS: This study offers an in-depth account of how female residents specifically experience and cope with medical errors. Our interviews with female residents convey the sense that gender possibly influences the experience with errors, including the kind of coping mechanisms displayed. However, we acknowledge that the lack of a direct comparison between female and male participants represents a limitation while aiming to explore the role of gender.
机译:背景:医生,尤其是住院医生等受过培训的医生会犯错误。即使当今的错误处理方法强调系统性因素,他们也必须面对后果。医生的个性特征在医疗错误的经历和处理中起着重要作用。先前在一些定量研究中已经检验了性别的作用,这些研究产生了矛盾的结果。在本研究中,我们试图定性探索女性居民在医疗错误方面的经验。特别是,我们探讨了错误后显示的应对机制。这项研究是在瑞士大学医院的内科进行的。方法:在现象学的框架内,对八名女性内科常规住院医师进行了半结构化访谈。结果:访谈产生了七个主要主题:(1)认为没有足够的安全和错误文化; (2)察觉到的主要错误原因,包括疲劳,工作超负荷,与分配的任务有关的能力不足以及沟通不畅; (3)对错误的消极情绪,包括不同形式的心理困扰; (4)等级制度对涉及错误的居民的不同态度; (5)谈论错误,作为核心应对机制; (六)对自己错误的防御性和建设性态度; (7)与错误有关的性别特定经验。此类经历包括(a)认为男性居民比女性居民更自信,因此受错误影响较小;(b)认为男性主管之间的性别歧视态度可能发生并加剧已经很痛苦的经历。结论:本研究提供了一个深入说明女性居民如何具体体验和应对医疗错误。我们与女性居民的访谈传达出一种感觉,即性别可能会影响错误体验,包括所显示的应对机制。但是,我们承认,在试图探讨性别角色时,男女参与者之间缺乏直接比较是一个局限。

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