Improving disclosure of medical error through educational program as a first step toward patient safety.

BACKGROUND: Although physicians believe that medical errors should be disclosed to patients and their families, they often hesitate to do so. In this study, we assessed the effectiveness of an education program for medical error disclosure. METHODS: In 2015, six medical interns and 79 fourth-year medical students participated in this study. The education program included practice of error disclosure using a standardized patient scenario, feedback, and short didactic sessions. Participant performance was evaluated with a previously developed rating scale that measures error disclosure performance on five specific component skills. Following education program, we surveyed participant perceptions of medical error disclosure with varying severity of error outcome and their satisfaction with the education program using a 5-point Likert scale. We also surveyed the change of attitude or confidence of participants after education program. RESULTS: The performance score was not significantly different between medical interns and medical students (p = 0.840). Following the education program, 65% of participants said that they had become more confident in coping with medical errors, and most participants (79.7%) were satisfied with the education program. They also indicated that they felt a greater duty to disclose medical errors and deliver an apology when the medical error outcome is more severe. CONCLUSIONS: An education program for disclosing medical errors was helpful in improving confidence in medical error disclosure. Extending the program to more diverse scenarios and a more diverse group of physicians is needed.

Predictors of Undergraduate and Postgraduate Clinical Performance: A Longitudinal Cohort Study.

OBJECTIVE: Though many medical schools applied various admission criteria in the selection process, the evidence of using those criteria is unclear. This study examined the predictive validity of each admission criterion for student competency. DESIGN, SETTING, AND PARTICIPANTS: We conducted a prospective cohort study of all students who matriculated to Seoul National University School of Medicine from 2002 to 2008. Demographic characteristics, admission criteria scores, and clinical competencies based on grade point average (GPA), objective structured clinical examination score, and internship score were obtained for each student to analyze the predictive validity of admission criteria. RESULTS: Graduate GPA at the end of 4 years positively correlated with preadmission GPA (p < 0.0001) and written test score (p = 0.012) but negatively correlated with essay test (p = 0.049). Internship score significantly correlated with preadmission GPA and graduate GPA. Regression analysis revealed that the preadmission GPA of the affiliated college and young age at admission could predict GPA, and preadmission GPA and graduate GPA could predict the internship score, which indicates postgraduate clinical performance. CONCLUSIONS: These findings suggest that preadmission GPA is a reliable predictor of academic achievement during medical school and postgraduate clinical performance. For assessing nonacademic competencies, further research is needed.