The Function of Disclosing Medical Errors: New Cultural Challenges for Physicians.

A general consensus has been reached in health care organizations that the disclosure of medical errors can be a very powerful way to improve patients and physicians well-being and serves as a core component to high quality health care. This practice strongly encourages transparent communication with patients after medical errors or unanticipated outcomes. However, many countries, such as Brazil, do not have a culture of disclosing harmful errors to patients or standards emphasizing the importance of disclosing, taking responsibility, apologizing, and discussing the prevention of recurrences. Medical error is not discussed or approached during medical school. The stigma of error has a strong connection with value judgments, and emotional support for physicians does not exist. This paper suggests that open communication with the patient is essential. Guidance about error disclosure from health care organizations would be helpful for quality and patient safety and for health care professionals in countries like Brazil.

Medical residents' mental distress in the COVID-19 pandemic: An urgent need for mental health care.

PURPOSE: Medical residents' mental health is currently an issue of concern for medical educators worldwide. The COVID-19 pandemic has raised the greatest concerns given the psychological effects of this scenario on medical residents on the frontlines of the pandemic. To assess the psychological impact of the COVID-19 pandemic on physicians in residency training, the collective symptoms of burnout, depression and anxiety are used to identify the residents' beliefs and clinical practices related to COVID-19 patients and their behaviors concerning disease prevention. METHOD: This observational study involved 3071 medical residents from all regions of Brazil. An online questionnaire assessed the presence of burnout using the Oldenburg Burnout Inventory, depressive symptoms using the Patient Health Questionaire-9, anxiety symptoms using the Generalized Anxiety Disorder-7, and COVID-19 Impact Questions to assess the residents' beliefs and clinical practices related to COVID-19 patients. Exploratory analyses, logistic regression and multinomial regression analysis were performed in this investigation. RESULTS: Moderate and severe depressive symptoms were the most common (67.7%) followed by anxiety symptoms (52.8%) and burnout (48.6%). The difference between residents with or without contact with COVID-19 patients was significant increased when analyzing different aspects of clinical practice, behavior, substance use and mental health. CONCLUSIONS: These results suggest an increase in depression and anxiety symptoms among medical residents dealing with COVID-19, upstaging previous concerns about medical residents' mental health. The prevalence of burnout is similar to that of a nonpandemic scenario. Considering the severity of the pandemic scenario and the overburden of healthcare services, medical residents' mental health deserves special care.

Mental health and the COVID-19 pandemic: a study of medical residency training over the years.

OBJECTIVES: This study aims to assess the symptoms of burnout, depression, and anxiety in Brazilian medical residents during the COVID-19 pandemic and to compare residents' beliefs and clinical practices related to COVID-19 patients among all six years of medical residency training in Brazil. METHODS: A quantitative study was conducted in April 2020 with a convenience sample of medical resident volunteers from an anonymous online survey. This investigation collected sociodemographic information and used the Oldenburg Burnout Inventory (OLBI) to measure burnout, the Patient Health Questionnaire (PHQ-9) to measure depression, and the General Anxiety Disorders (GAD-7) to measure generalized anxiety disorder. This study also developed a COVID-19 Impact Questionnaire (CIQ-19) to assess the residents' beliefs and clinical practices related to COVID-19 patients. RESULTS: Our sample comprised 3071 respondents. Depressive symptoms were the most common among second-year residents (70.5%), followed by anxiety symptoms (56.0%) and burnout (55.2%) among fourth-year residents. We also observed burnout symptoms (55.1%) among second-year residents. CONCLUSION: The COVID-19 pandemic increased the risk of mental illnesses in some years of residency. Our study could not conclude the reasons why the incidence varies among levels of physician training. Final year medical residents have avoided seeing COVID-19 patients.

Physicians' attitudes regarding the disclosure of medical errors: A qualitative study.

The experiences of physicians' errors could affect their professional practice. The aim of study was to explore physicians' experiences of medical errors and its consequences. This was a qualitative study in which ten Brazilian physicians were selected through purposive sampling. The data were collected via semistructured interviews and analyzed through principles derived of the phenomenological method. The interview topics were around how the error occurred in their practice, its process of disclosure and consequences of medical errors. Excessive workload and difficulty communicating among physicians are some of the factors that may increase the likelihood of medical error. Not looking for help after the error was a common attitude. This may be related to the difficulty for some physicians to acquire new practices after the error, even though physicians have shown that experiencing a medical error situation has a negative impact in their lives. To disclose training and institutional practices which contribute to the dissemination of conduct favorable to the improvement of medical practice.

Mental health and the COVID-19 pandemic: a study of medical residency training over the years

OBJECTIVES: This study aims to assess the symptoms of burnout, depression, and anxiety in Brazilian medical residents during the COVID-19 pandemic and to compare residents' beliefs and clinical practices related to COVID-19 patients among all six years of medical residency training in Brazil. METHODS: A quantitative study was conducted in April 2020 with a convenience sample of medical resident volunteers from an anonymous online survey. This investigation collected sociodemographic information and used the Oldenburg Burnout Inventory (OLBI) to measure burnout, the Patient Health Questionnaire (PHQ-9) to measure depression, and the General Anxiety Disorders (GAD-7) to measure generalized anxiety disorder. This study also developed a COVID-19 Impact Questionnaire (CIQ-19) to assess the residents' beliefs and clinical practices related to COVID-19 patients. RESULTS: Our sample comprised 3071 respondents. Depressive symptoms were the most common among second-year residents (70.5%), followed by anxiety symptoms (56.0%) and burnout (55.2%) among fourth-year residents. We also observed burnout symptoms (55.1%) among second-year residents. CONCLUSION: The COVID-19 pandemic increased the risk of mental illnesses in some years of residency. Our study could not conclude the reasons why the incidence varies among levels of physician training. Final year medical residents have avoided seeing COVID-19 patients.