Exploring the fear of clinical errors: associations with socio-demographic, professional, burnout, and mental health factors in healthcare workers - A nationwide cross-sectional study.

Background: The fear of clinical errors among healthcare workers (HCW) is an understudied aspect of patient safety. This study aims to describe this phenomenon among HCW and identify associated socio-demographic, professional, burnout and mental health factors. Methods: We conducted a nationwide, online, cross-sectional study targeting HCW in France from May to June 2021. Recruitment was through social networks, professional networks, and email invitations. To assess the fear of making clinical errors, HCW were asked: "During your daily activities, how often are you afraid of making a professional error that could jeopardize patient safety?" Responses were collected on a 7-point Likert-type scale. HCW were categorized into "High Fear" for those who reported experiencing fear frequently ("once a week," "a few times a week," or "every day"), vs. "Low Fear" for less often. We used multivariate logistic regression to analyze associations between fear of clinical errors and various factors, including sociodemographic, professional, burnout, and mental health. Structural equation modeling was used to explore how this fear fits into a comprehensive theoretical framework. Results: We recruited a total of 10,325 HCW, of whom 25.9% reported "High Fear" (95% CI: 25.0-26.7%). Multivariate analysis revealed higher odds of "High Fear" among males, younger individuals, and those with less professional experience. High fear was more notable among physicians and nurses, and those working in critical care and surgery, on night shifts or with irregular schedules. Significant associations were found between "High Fear" and burnout, low professional support, major depressive disorder, and sleep disorders. Conclusions: Fear of clinical errors is associated with factors that also influence patient safety, highlighting the importance of this experience. Incorporating this dimension into patient safety culture assessment could provide valuable insights and could inform ways to proactively enhance patient safety.

Surgeon and Surgical Trainee Experiences After Adverse Patient Events.

Importance: Adverse patient events are inevitable in surgical practice. Objectives: To characterize the impact of adverse patient events on surgeons and trainees, identify coping mechanisms, and assess whether current forms of support are sufficient. Design, Setting, and Participants: In this mixed-methods study, a validated survey instrument was adapted and distributed to surgical trainees from 7 programs, and qualitative interviews were conducted with faculty from 4 surgical departments in an urban academic health system. Main Outcomes and Measures: The personal impact of adverse patient events, current coping mechanisms, and desired forms of support. Results: Of 216 invited trainees, 93 (43.1%) completed the survey (49 [52.7%] male; 60 [64.5%] in third postgraduate year or higher; 23 [24.7%] Asian or Pacific Islander, 6 [6.5%] Black, 51 [54.8%] White, and 8 [8.6%] other race; 13 [14.0%] Hispanic or Latinx ethnicity). Twenty-three of 29 (79.3%) invited faculty completed interviews (13 [56.5%] male; median [IQR] years in practice, 11.0 [7.5-20.0]). Of the trainees, 77 (82.8%) endorsed involvement in at least 1 recent adverse event. Most reported embarrassment (67 of 79 trainees [84.8%]), rumination (64 of 78 trainees [82.1%]), and fear of attempting future procedures (51 of 78 trainees [65.4%]); 28 of 78 trainees (35.9%) had considered quitting. Female trainees and trainees who identified as having a race and/or ethnicity other than non-Hispanic White consistently reported more negative consequences compared with male and White trainees. The most desired form of support was the opportunity to discuss the incident with an attending physician (76 of 78 respondents [97.4%]). Similarly, faculty described feelings of guilt and shame, loss of confidence, and distraction after adverse events. Most described the utility of confiding in peers and senior colleagues, although some expressed unwillingness to reach out. Several suggested designating a departmental point person for event debriefing. Conclusions and Relevance: In this mixed-methods study of the personal impact of adverse events on surgeons and trainees, these events were nearly universally experienced and caused significant distress. Providing formal support mechanisms for both surgical trainees and faculty may decrease stigma and restore confidence, particularly for underrepresented groups.

Lebanese medical students' attitudes towards patient safety and medical error disclosure: A cross-sectional study.

OBJECTIVE: To assess Lebanese medical students' attitudes towards patient safety and medical error disclosure. METHODS: This was a cross-sectional study involving medical students from seven different medical schools in Lebanon. The participants completed the Attitudes to Patient Safety Questionnaire (APSQ-III) online, which consists of 26 items across nine key patient safety domains. Items were scored from 1 (strongly disagree) to 5 (strongly agree). Demographic data were also collected. RESULTS: Of the 549 students enrolled in the study, 325 (59%) were female and 224 (41%) were male. More than half (287, 52%) were aged between 20 and 22 years and 95% were Lebanese. The overall attitude of students towards patient safety was positive (3.59 ± 0.85) with the most positive attitudes in the domains of 'Team functioning' followed by 'Working hours as an error cause'. More positive attitudes were perceived among male students in the domains of 'Professional incompetence as an error cause' and 'Disclosure responsibility' whereas more positive attitudes were seen in female students in the domain of 'Working hour as an error cause'. Older medical students had more positive attitudes in the domain of 'Team functioning' than younger students. CONCLUSION: Medical students in Lebanon had an overall positive attitude towards patient safety. These findings may be used to guide improvements in patient safety education and enhance patient-centred care in medical institutions in Lebanon.

Is there a relationship between nursing students' perceptions of dishonesty and attitudes towards medical errors?

BACKGROUND: Understanding nursing students' perceptions of dishonesty and their attitudes towards medical errors is crucial for nurse educators. OBJECTIVES: This study aimed to examine the relationship between nursing students' perceptions of dishonesty and their attitudes towards medical errors. DESIGN: This study is descriptive and correlational research. The sample size consisted of 230 nursing students in a Department of Nursing at Kirsehir Ahi Evran University Faculty of Health Sciences in Turkey during the 2022-2023 academic year. The data was collected between May 15-31, 2023. RESULTS: A statistically significant correlation was observed between the total score of the Nursing Student Perceptions of Dishonesty Scale, and the Medical Errors Attitude Scale (p < 0.05). There was a positive and weak correlation between the MEAS scale score and the cheating (r = 0.284, p < 0.05), sabotage (r = 0.275, p < 0.05), perjury (r = 0.308, p < 0.05), non-compliance (r = 0.309, p < 0.05), and stealing (r = 0.359, p < 0.05) sub dimension score, and a positive and very weak correlation between the MEAS score and the sub dimension of not my problem score (r = 0.182, p < 0.05). The perceptions of dishonesty explain 15 % of the attitude towards medical errors (F = 4.563, p < 0.001). CONCLUSIONS: In this study, a significant relationship was observed between nursing students' perceptions of dishonesty and their attitudes towards medical errors. Specifically, as the perception of dishonesty increased, there was a positive change in attitudes towards medical errors. These results offer nurse educators valuable insights into the impact of academic dishonesty on the development of medical error attitudes among student nurses throughout their nursing education and beyond.

Assessing the stops framework for coping with intraoperative errors: Evidence of efficacy, hints of hubris, and a bridge to abridging burnout.

BACKGROUND: Answering calls in the literature, we developed and introduced an evidence-based tool for surgeons facing errors in the operating room: the STOPS framework (stop, talk to you team, obtain help, plan, succeed). The purpose of this research was to assess the impact of presenting this psychological tool on resident coping in the operating room and the related outcome of burnout while examining sex differences. METHODS: In a natural experiment, general surgery residents were invited to attend 2 separate educational conferences regarding coping with errors in the operating room. Three months later, all residents were asked to fill out a survey assessing their coping in the operating room, level of burnout, and demographics. We assessed the impact of the educational intervention by comparing those who attended the coping conferences with those who did not attend. RESULTS: Thirty-five residents responded to the survey (65% response rate, 54% female respondents, 49% junior residents). Our hypothesized moderated mediation model was supported. Sex was found to moderate the impact of the STOPS framework-female residents who attended the coping educational conference reported higher coping self-efficacy, whereas attendance had no statistically significant impact on male levels of coping self-efficacy. In turn, higher coping self-efficacy was associated with lower levels of burnout. CONCLUSION: Our results suggest that there is evidence of efficacy in this instruction-female residents presented this material report higher levels of coping in the operating room compared to those who did not receive the framework. Further, increase in coping ability was associated with reduced levels of burnout for both genders.

Intraoperative adverse events among surgeons in Singapore: a multicentre cross-sectional study on impact and support.

BACKGROUND: It is known that many surgeons encounter intraoperative adverse events which can result in Second Victim Syndrome (SVS), with significant detriment to their emotional and physical health. There is, however, a paucity of Asian studies in this space. The present study thus aimed to explore the degree to which the experience of an adverse event is common among surgeons in Singapore, as well as its impact, and factors affecting their responses and perceived support systems. METHODS: A self-administered survey was sent to surgeons at four large tertiary hospitals. The 42-item questionnaire used a systematic closed and open approach, to assess: Personal experience with intraoperative adverse events, emotional, psychological and physical impact of these events and perceived support systems. RESULTS: The response rate was 57.5% (n = 196). Most respondents were male (54.8%), between 35 and 44 years old, and holding the senior consultant position. In the past 12 months alone, 68.9% recalled an adverse event. The emotional impact was significant, including sadness (63.1%), guilt (53.1%) and anxiety (45.4%). Speaking to colleagues was the most helpful support source (66.7%) and almost all surgeons did not receive counselling (93.3%), with the majority deeming it unnecessary (72.2%). Notably, 68.1% of the surgeons had positive takeaways, gaining new insight and improving vigilance towards errors. Both gender and surgeon experience did not affect the likelihood of errors and emotional impact, but more experienced surgeons were less likely to have positive takeaways (p = 0.035). Individuals may become advocates for patient safety, while simultaneously championing the cause of psychological support for others. CONCLUSIONS: Intraoperative adverse events are prevalent and its emotional impact is significant, regardless of the surgeon's experience or gender. While colleagues and peer discussions are a pillar of support, healthcare institutions should do more to address the impact and ensuing consequences.

Disclosure following a medical error: lessons learned from a national initiative of workshops with patients, healthcare teams, and executives.

BACKGROUND: Despite the increase in disclosures of medical errors, transparency remains a challenge. Recognized barriers include shame, fear of litigation, disciplinary actions, and loss of patient trust. In 2018, the Israeli Ministry of Health initiated a series of workshops about disclosure of medical errors. The workshops involved medical center executives, healthcare providers, patients, and family members of patients who had previously been harmed by a medical error. This study presents the lessons learned about perceived challenges in disclosure of errors in 15 such workshops. METHODS: Data collection included participant observations in 15 workshops, full audio recordings of all of the workshops, and documentation of detailed field notes. Analysis was performed under thematic analysis guidelines. RESULTS: We identified four main themes: "Providers agree on the value of disclosure of a medical error to the patient"; "Emotional challenges of disclosure of medical error to patients"; "The medico-legal discourse challenges transparency"; and "Providers and patients call for a change in the culture regarding disclosure of medical errors". Participant observations indicated that the presence of a patient who had experienced a tragedy in another hospital, and who was willing to share it created an intimate atmosphere that enabled an open conversation between parties. CONCLUSION: The study shows the moral, human, and educational values of open discourse in a protective setting after the occurrence of a medical error. We believe that workshops like these may help foster a culture of institutional disclosure following medical errors. We recommend that the Ministry of Health extend such workshops to all healthcare facilities, establish guidelines and mandate training for skills in disclosure for all providers.

Patients' and doctors' views and experiences of the patient safety trajectory of breast cancer care.

INTRODUCTION: Successful breast cancer outcomes can be jeopardised by adverse events. Understanding and integrating patients' and doctors' perspectives into care trajectories could improve patient safety. This study assessed their views on, and experiences of, medical error and patient safety. METHODS: A cross-sectional, quantitative 20-40 item questionnaire for patients attending Cork University Hospital Cancer Centre and breast cancer doctors in the Republic of Ireland was developed. Domains included demographics, medical error experience, patient safety opinions and concerns. RESULTS: 184 patients and 116 doctors completed the survey. Of the doctors, 41.4% felt patient safety had deteriorated over the previous five years and 54.3% felt patient safety measures were inadequate compared to 13.0% and 27.7% of patients respectively. Of the 30 patients who experienced medical errors/negligence claims, 18 reported permanent or long-term physical and emotional effects. Forty-two of 48 (87.5%) doctors who experienced medical errors/negligence claims reported emotional health impacts. Almost half of doctors involved in negligence claims considered early retirement. Forty-four patients and 154 doctors didn't experience errors but reported their patient safety concerns. Doctors were more concerned about communication and administrative errors, staffing and organisational factors compared to patients. Multiple barriers to error reporting were highlighted. CONCLUSION: This is the first study to assess patients' and doctors' patient safety views and medical error/negligence claims experiences in breast cancer care in Ireland. Experience of medical error/negligence claims had long-lasting implications for both groups. Doctors were concerned about a multitude of errors and causative factors. Failure to embed these findings is a missed opportunity to improve safety.

Exploring the Factors that Drive Clinical Negligence Claims: Stated Preferences of Those Who Have Experienced Unintended Harm.

BACKGROUND: Better understanding of the factors that influence patients to make a financial claim for compensation is required to inform policy decisions. This study aimed to assess the relative importance of factors that influence those who have experienced a patient safety incident (PSI) to make a claim for compensation. METHOD: Participants completed an online discrete choice experiment (DCE) involving 10 single profile tasks where they chose whether or not to file a claim. DCE data were modelled using logistic, mixed logit and latent class regressions; scenario analyses, external validity, and willingness to accept were also conducted. RESULTS: A total of 1029 participants in the United Kingdom responded to the survey. An appropriate apology and a satisfactory investigation reduced the likelihood of claiming. Respondents were more likely to claim if they could hold those responsible accountable, if the process was simple and straightforward, if the compensation amount was higher, if the likelihood of compensation was high or uncertain, if the time to receive a decision was quicker, and if they used the government compensation scheme. Men are more likely to claim for low impact PSIs. DISCUSSION AND CONCLUSIONS: The actions taken by the health service after a PSI, and people's perceptions about the probability of success and the size of potential reward, can influence whether a claim is made. Results show the importance of giving an appropriate apology and conducting a satisfactory investigation. This stresses the importance around how patients are treated after a PSI in influencing the clinical negligence claims that are made.

Coping trajectories of intensive care nurses as second victims: A grounded theory.

A qualitative study that provides evidence of the institutional support required by intensive care unit (ICU) nurses as second victims of adverse events (AEs). BACKGROUND: The phenomenon of second victims of AE in healthcare professionals can seriously impact professional confidence and contribute to the ongoing occurrence of AEs in hospitals. OBJECTIVES: The objective of this study was to describe the coping trajectories of second victims among nurses working in ICUs in public hospitals in Chile. METHODS: Conducting qualitative research through the grounded theory method, this study focused on high-complexity hospitals in Chile, using theoretical sampling. The participants consisted of 11 nurses working in ICUs. Techniques used included in-depth interviews conducted between March and May 2023, as well as a focus group interview. Analysis, following the grounded theory approach proposed by Strauss and Corbin, involved constant comparison of data. Open, axial, and selective coding were applied until theoretical data saturation was achieved. The study adhered to reliability and authenticity criteria, incorporating a reflexive process throughout the research. Ethical approval was obtained from the ethics committee, and the study adhered to the consolidated criteria for reporting qualitative research. RESULTS: From the interviews, 29 codes were identified, forming six categories: perception of support when facing an AE, perception of helplessness when facing an AE, initiators of AE, responses when facing an AE, professional responsibility, and perception of AE. The perception of support when facing an AE emerged as the main category, determining whether the outcome was stagnation or overcoming of the phenomenon after the AE. CONCLUSIONS: For the coping process of ICU nurses following an AE, the most crucial factor is the support from colleagues and supervisors.

Second-Victim Phenomenon.

All in health care are at risk of involvement in adverse events. Oftentimes, the health care worker manifests physical, psychological, and professional effects and this is referred to as the second-victim phenomenon. Unmitigated recovery of a second victim can contribute to absenteeism, turnover intentions, burnout, and loss of joy and meaning in work. The preferred method of support among health care workers is a respected peer to provide emotional support. Health care organizations can contribute to a second victim's recovery by providing a culture of safety and diverse resources based on the needs of the individual.

Use of the Second Victim Experience and Support Tool (SVEST) to Assess the Impact of a Departmental Peer Support Program on Anesthesia Professionals' Second Victim Experiences (SVEs) and Perceptions of Support Two Years After Implementation.

Anesthesia professionals experience events resulting in psychological and physiologic implications, known as second victim experiences (SVEs). This study evaluated the impact of a peer support program on anesthesia providers' SVEs. In July 2018, a departmental peer support program was implemented. All anesthesia professionals were invited to participate in a survey, including the Second Victim Experience and Support Tool (SVEST), which evaluated SVEs and desired support, preimplementation of the program. The survey was repeated two years after program implementation. A total of 57.9% (348/601) completed the preimplementation survey; 37.6% (231/614) completed the postimplementation survey. The median SVEST scores for psychological distress (3.0 vs 2.8, P = .04) and institutional support (3.0 vs 2.3, P < .001) were significantly lower on the postimplementation survey, indicating more favorable responses. For both assessments, the most desired support option was a 'respected peer to discuss the details of what happened.' Postimplementation, 84.9% (191/225) agreed the program enhanced departmental support, 93.2% (207/222) agreed the program considered professionals' well-being, and 81.7% (183/224) agreed the program contributed to a culture of safety. A total of 99.1% (213/215) would recommend the peer support program to others. Implementation of a peer support program significantly influenced anesthesia professionals' SVE-related psychologic distress and perception of adequate institutional support.

[Patient safety 4.0: "Failure of the Week" It's all about role modelling!] / Patient*innen-Sicherheit 4.0: "Fehler der Woche" ­ Um die Vorbildfunktion geht's!

BACKGROUND: The rate of mistakes and near misses in clinical medicine remains staggering. The tendency to cover up mistakes is rampant in "name-blame-shame" cultures. The need for safe forums where mistakes can be openly discussed in the interest of patient safety is evident. Following a comprehensive review of the literature, a semi-structured weekly conference, named "mistake of the week" (MOTW), was introduced, enabling physicians to voluntarily discuss their mistakes and near-misses. The MOTW is intended to encourage cultural change in how physicians approach, process, accept and learn from their own and their peers' mistakes. This study seeks to assess if physicians appreciate, benefit from and are motivated to participate in MOTW. METHODS: Physicians and medical students of the I. and II. Medizinische Klinik at the Academic Teaching Hospital Klinikum Konstanz (Germany) were eligible to participate voluntarily. Four groups of physicians (n=3-6) and one group of medical students (n=5) volunteered to participate in focus group interviews, which were videotaped, transcribed and analyzed. RESULTS: The following success factors are crucial for dealing with and voluntarily disclosing mistakes and near-misses: 1. Exemplification ("follow the boss's lead"), 2. Fixed time slots and a clear forum, 3. Reporting mistakes without fear of penalty or punishment, 4. A trusting working atmosphere. The key effects of the MOTW approach are: 1. People report their mistakes more, 2. Relief, 3. Psychological safety, 4. Lessons learned/errors (potentially) reduced. DISCUSSION: The MOTW conference models an ideal forum to mitigate hierarchy and promote a sustainable organizational dynamic in which mistakes and near misses can be discussed in an environment free from "name-blame-shame", with the ultimate goal of potentially improving patient care and safety.

Residents, Responsibility, and Error: How Residents Learn to Navigate the Intersection.

PURPOSE: As a competency of Canadian postgraduate education, residents are expected to be able to promptly disclose medical errors and assume responsibility for and take steps to remedy these errors. How residents, vulnerable through their inexperience and hierarchical team position, navigate the highly emotional event of medical error is underexplored. This study examined how residents experience medical error and learn to become responsible for patients who have faced a medical error. METHOD: Nineteen residents from a breadth of specialties and years of training at a large Canadian university residency program were recruited to participate in semistructured interviews between July 2021 and May 2022. The interviews probed their experience of caring for patients who had experienced a medical error. Data collection and analysis were conducted iteratively using a constructivist grounded theory method with themes identified through constant comparative analysis. RESULTS: Participants described their process of conceptualizing error that evolved throughout residency. Overall, the participants described a framework for how they experienced error and learned to care for both their patients and themselves following a medical error. They outlined their personal development of understanding error, how role modeling influenced their thinking about error, their recognition of the challenge of navigating a workplace environment full of opportunities for error, and how they sought emotional support in the aftermath. CONCLUSIONS: Teaching residents to avoid making errors is important, but it cannot replace the critical task of supporting them both clinically and emotionally when errors inevitably occur. A better understanding of how residents learn to manage and become responsible for medical error exposes the need for formal training as well as timely, explicit discussion and emotional support both during and after the event. As in clinical management, graded independence in error management is important and should not be avoided because of faculty discomfort.

The role of demographic, job-related and psychological characteristics on the prevalence of repetitive patient safety incidents among Iranian nurses.

BACKGROUND: Job-related psychosocial factors have a substantial effect on the occurrence of adverse events among healthcare professionals. OBJECTIVE: An analytical and descriptive survey was conducted to evaluate the relationship between the occurrence of patient safety incidents and psychological factors. METHODS: The study sample consisted of 177 nurses who were asked about patient safety events over six months. Repetitive patient safety incidents were selected by examining medical records and interviewing specialists. Also, psychological factors were assessed using job content questionnaire (JCQ). RESULTS: Repetitive patient safety incidents were involved medication administration error, pressure ulcer and skin-muscular injuries, patient falls, inability to CPR patients, blood transfusion reactions, and death due to human error. The findings showed that 92 participants (52%) had at least one case of patient safety incident. Among patient safety incidents, medication administration error and death due to human error had the highest and lowest repletion, respectively. Nurses training, job insecurity and peer support were significant predictors of different aspects of patient safety (p < 0.05). CONCLUSION: Proper collaboration between new and experienced nurses can have a significant impact to reduce patient safety incidents. In addition, nursing training can be a good way to understand risk points in medical errors.

["I WOULD COME HOME WITH TEARS IN MY EYES:" THE CLINICIAN AS A SECOND VICTIM ON A DAY-TO-DAY ROUTINE AND AT THE COVID-19 PANDEMIC].

BACKGROUND: Until the onset of the new millennium, the focus of medicine in general and patient safety in particular was the patient. In the past two decades, the well-being of the clinician is becoming more apparent in the professional literature. This article will focus on the physician who shows signs of distress, depression and burnout, or even trauma. This is the second victim of a medical error or adverse event. METHODS: The author will review the literature of the past decade dealing with this phenomenon, often related to as a syndrome, in day-to-day routine and at a pandemic and emergency situation. I will start by the definition and description of symptoms of the syndrome, then move on to its scope, risk factors and various sources. CONCLUSIONS: I will conclude by describing the situation in Israel and provide some practical tools that have proved efficient for confronting the phenomenon. DISCUSSION: The author will focus on the four origins of stress leading to the syndrome: the physical-psychological, institutional-cultural, cognitive and moral. I will emphasize the latter, which deserves further exploration given the evidence to its significant contribution to stress and trauma of health professionals. I will then discuss the interventions and tools suggested and implemented for support of the second victim in relation to the four origins.

STOPS: A Coping Framework for Surgeons Who Experience Intraoperative Error.

OBJECTIVE: To investigate the steps faculty surgeons take upon experiencing intraoperative error and synthesize these actions to offer a framework for coping with errors. BACKGROUND: While intraoperative errors are inevitable, formal training in error recovery is insufficient and there are no established curricula that teach surgeons how to deal with the intraoperative error. This is problematic because insufficient error recovery is detrimental to both patient outcomes and surgeon psychological well-being. METHODS: We conducted a thematic analysis. One-hour in-depth semistructured interviews were conducted with faculty surgeons from 3 hospitals. Surgeons described recent experiences with intraoperative error. Interviews were transcribed and coded. Analysis allowed for development of themes regarding responses to errors and coping strategies. RESULTS: Twenty-seven surgeons (30% female) participated. Upon completion of the analysis, themes emerged in 3 distinct areas: (1) Exigency, or a need for training surgical learners how to cope with intraoperative errors, (2) Learning, or how faculty surgeons themselves learned to cope with intraoperative errors, and (3) Responses, or how surgeons now handle intraoperative errors. The latter category was organized into the STOPS framework: Intraoperative errors could produce STOPS: Stop, Talk to your Team, Obtain Help, Plan, Succeed. CONCLUSIONS AND RELEVANCE: This study provides both novel insight into how surgeons cope with intraoperative errors and a framework that may be of great use to trainees and faculty alike.

Medical errors: Experiences, attitudes and perspectives of incoming and outgoing final-year veterinary students in the USA.

BACKGROUND: Medical errors have an impact on veterinary patient safety. Studies in human medicine suggest that students can help prevent medical errors. However, there are no studies that address the role of veterinary students in patient safety. METHODS: An electronic survey was distributed to incoming final-year (IFY) and outgoing final-year (OFY) students at the Washington State University College of Veterinary Medicine. Response data were compared between class year groups with a Fisher's exact test and Mann-Whitney U test. RESULTS: The response rate was 26.8% (70/261). Most respondents (85.7%) reported being present during a medical error, and 60% reported causing a medical error. The OFY group indicated lower agreement with documenting an error in the patient record and whether all errors should be disclosed. The IFY group felt more distress surrounding potential errors and sequential career implications. Compared with the IFY group, the OFY group agreed more that errors occur frequently in veterinary medicine and disagreed more that hospital staffing is adequate to ensure patient safety. Open responses recognised a need for communication training and identified that the OFY group regarded errors more actionably, whereas the IFY group viewed errors more emotionally. CONCLUSION: Most veterinary students will experience medical errors prior to graduation, but some lack clarity around appropriate disclosure and documentation. Additional training on medical errors and error disclosure should be provided to veterinary students.