Junior doctors and nurses' views and experiences of medical error: Moving toward shared learning and responsibility

Background: Current guidelines for incident management and open disclosure emphasize team collaboration and openness yet little is known about how and to what extent junior doctors and nurses view and integrate these principles into their learning and practices. Purpose: This research aimed to compare and contrast junior doctors and nurses' attitudes and experiences regarding medical error and open disclosure and how they would disclose errors. Method: Junior doctors and nurses completed a survey containing closed item questions and free text responses to two hypothetical scenarios. Results: The results indicated that the majority of respondents had personal involvement with near misses but experience with minor or serious errors were less common. Few had disclosed an error. Almost all agreed a serious error should be disclosed and 84% believed minor errors should be disclosed. Interns and nurses significantly differed in their views about the cause and importance of medical error and in their prior training experiences. Differences were also observed in the types of steps that respondents would take in managing an error. There was little recognition of the need to apologize when disclosing errors or to share the responsibility between the two professions. Conclusions: Knowledge gaps and different orientations toward error management and open disclosure between the two professional groups were evident. Interprofessional education specifically targeting junior doctors and nurses and promoting the concept of team disclosure is needed. Such training should form an essential part of a health organization's response to medical error.