Physicians-in-training are highly vulnerable to making medical errors that stem from teamwork breakdowns, especially a lack of supervision by experienced staff, according to a new study funded by the Department of Health & Human Services’ Agency for Healthcare Research and Quality (AHRQ). Teamwork breakdowns involving medical residents, fellows, and first-year residents also caused a significant number of errors to occur during patient handoffs, researchers found. The study, “Medical Errors Involving Trainees: A Study of Closed Malpractice Claims from 5 Insurers,” appears in the Oct. 22, 2007, issue of the Archives of Internal Medicine.
Researchers analyzed data from a random sample of 889 closed malpractice claims that had been reviewed between 2002 and 2004. The study focused on four clinical categories: obstetrics, surgical, missed and delayed diagnoses, and medications. Of the closed claims involving both error and injury, 27 percent, or 240 cases, involved trainees whose role in the error was considered to be at least moderately important, the study found. Cognitive factors contributed to the majority of trainee errors, according to the study. Nearly three-fourths (72 percent) involved errors in judgment, and more than half were caused by a lack of technical knowledge (58 percent) or were due to failure of vigilance or memory (57 percent). Teamwork factors, notably lack of supervision and handoff problems, accounted for 70 percent of the cases involving trainee errors. Read the abstract.
