Supervision and responses of psychiatry residents to adverse patient events.

ABSTRACT

OBJECTIVE: Throughout training, psychiatry residents may experience adverse patient outcomes. The purpose of this study was to explore whether residents' perceptions of the quality of their supervision impacts their emotional reactions to adverse events. METHODS: All psychiatry residents from a training program at an academic medical center who were in their PGY2-4 years, as well as those in their first year out of training, were recruited to participate. Those who self-identified as having experienced an adverse event participated in a semi-structured interview. For the purpose of the study, "adverse event" was defined as follows patient suicide, patient homicide or homicide attempt outside the hospital, patient violence inside the hospital, life-threatening reaction to psychotropic medication, and physical assault of a resident by a patient. RESULTS: In this sample, 22 of the 64 residents (34 %) reported experiencing an adverse event. Of these, 21/22 (95 %) participated in the interview. Two residents reported experiencing two adverse events; the total number of adverse events analyzed was 23. For 21/23 (91 %) of these events, respondents felt that the quality of the supervision they received impacted their emotional reactions to the event. CONCLUSION: The supervisory relationship appears to play a significant role in how residents experience, and potentially learn from, adverse events; this has practical implications for educators and leaders.