Trainees in good position to comment on adverse events

A US study in Archives of Internal Medicine argues that trainee doctors are in a unique position to comment on adverse events.

The trainees were surveyed about their experience of adverse events, mistakes, near misses and their potential causes. The most common reasons for mistakes were excessive work hours, inadequate supervision and problems with handoffs. In the week before completing the survey, 18% of residents reported having a patient with an adverse event, and of these 37% reported that the adverse event involved a mistake for which they considered themselves responsible.

The authors of the report argue that their findings are important for several reasons: 

• They add to existing evidence that adverse events are common, and often associated with errors  
• They suggest that serious adverse events occur more frequently than has been previously suggested  
• Surgical residents were more likely to report adverse events, perhaps because they are more common in surgical specialties  
• The findings add to recent studies that long hours lead to increased errors.
  

They also suggest that some residents may find it difficult to identify adverse events, citing the fact that although adverse incidents are common, yet almost half of residents said they had not experienced one.

The study concludes that hospitals should involve residents in quality improvement initiatives - their involvement will offer both a complementary source of data and serve as an intervention at an opportune time in the doctors’ professional development.