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“I made a mistake!”: a narrative analysis of experienced physicians’ stories of preventable error
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  • Sujane Kandasamy,
  • Meredith Vanstone,
  • Eamon Colvin,
  • Teresa Chan,
  • Jonathan Sherbino,
  • Sandra Monteiro
Sujane Kandasamy
McMaster University
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Meredith Vanstone
McMaster University
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Eamon Colvin
University of Ottawa
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Teresa Chan
McMaster University, McMaster University
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Jonathan Sherbino
McMaster University
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Sandra Monteiro
McMaster University Faculty of Health Sciences
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Abstract

Rationale, aims, and objectives: The complexity of healthcare systems makes errors unavoidable. To strengthen the dialogue around how physicians experience and share medical errors, the objective of this study was to understand how experienced generalist physicians make meaning of and grow from their medical errors. Methods: This study used a narrative inquiry approach to conduct and analyze in-depth interviews from 26 physicians from the generalist specialties of emergency, internal, and family medicine. We gathered stories via individual interview, analyzed them for key components, and rewrote a ‘meta-story’ in a chronological sequence. We conceptualized the findings into a metaphor to draw similarities, learn from, and apply new principles from other fields of practice. Results: Through analysis we interpreted the story of an elite athlete (physician) who is required to make numerous decisions in a short period of time within the construct of a chaotic sports field (clinical environment) among spectators (the patient’s family) whilst abiding by existing rules and regulations. Through sharing stories of success and failure, the team coach (clinical mentor) helps optimize the players’ professional and psychological development. Similarly, through sharing and learning from stories, team members (colleagues) and junior team members (trainees) also contribute to the growth of the protagonist’s character and the development of the overall team (clinic/hospital) and sport (healthcare system). Conclusion: We draw parallels between the clinical setting and a generalist physician’s experiences of a medical error with the environment and practices within professional sports. Using this comparison, we discuss the potential for meaningful coaching in medical education.

Peer review status:Published

07 Aug 2020Submitted to Journal of Evaluation in Clinical Practice
10 Aug 2020Submission Checks Completed
10 Aug 2020Assigned to Editor
11 Aug 2020Reviewer(s) Assigned
30 Sep 2020Review(s) Completed, Editorial Evaluation Pending
30 Sep 2020Editorial Decision: Revise Major
28 Nov 20201st Revision Received
30 Nov 2020Assigned to Editor
30 Nov 2020Submission Checks Completed
04 Dec 2020Reviewer(s) Assigned
09 Dec 2020Review(s) Completed, Editorial Evaluation Pending
09 Dec 2020Editorial Decision: Revise Minor
09 Dec 20202nd Revision Received
10 Dec 2020Assigned to Editor
10 Dec 2020Submission Checks Completed
14 Dec 2020Review(s) Completed, Editorial Evaluation Pending
14 Dec 2020Editorial Decision: Accept
05 Jan 2021Published in Journal of Evaluation in Clinical Practice. 10.1111/jep.13531