DEBRIEFING AFTER NEGATIVE OUTCOMES
An online discussion led by Dr. Albert Wu, a renowned international expert on addressing the effects of negative outcomes on physicians.
2:40 – When did you decide to look at negative outcomes systematically? What made you interested in better understanding their impact and possible solutions?
6:50 – Can you tell us a little about the origins of the term “The second victim”?
9:10 – How close to home is this issue for you and do you have any advice for helping a colleague in the aftermath of a negative outcome?
11:30 – you mentioned providing emotional support of psychological 101. What would that look like?
13:20 – Has your research or your observations shown any common patterns specific to residents’ post-negative outcomes?
15:25 – What have you learned about successful debriefing strategies after negative outcomes?
16:35 – Is there an appropriate timeline as to when a debrief would be appropriate?
17:55 – Are there any red flags that residents should recognize within themselves or colleagues post-negative outcomes?
19:50 – Does our current model of teaching and learning support learners when making mistakes or does it contribute to the creation of the second victim? What’s your perspective on that?
21:30 – Given the dual role of residents as learners and clinicians, how do we change the learning environment to reflect the fact that errors are part of learning and can we create a safe space without sacrificing patient safety? Do you think that varies from specialty to specialty?
24:35 – Do we see differences in response to negative patient outcomes depending on the age of the victims?
27:45 – Many programs in universities hold M&M rounds. Do you think they play a positive role in helping residents navigate and learn from negative outcomes or can they also potentially be harmful?
30:25 – How different do you think the reactions are for residents between negative outcomes that are unrelated to an error vs those that have a possible error involved? What is your perspective?
34:05 – Do you think there is a possibility to let trainees fail in clinical training to let them learn better without harming the patient?
35:45 – Is there anything known as to whether black humour in the setting of negative outcomes is protective and resiliency-promoting vs. dehumanizing and demoralizing?
37:35 – What ways have you found useful to get more engagement and discussion from the public, the profession and between the two?
41:30 – Do you think programming in this area should be an accreditation standard?
43:05 – Have you had any negative responses from patient groups about the term “Second Victim”? Is this taking away from the centrality of the patients experience and what happened?
48:05 – Do you think fear of litigation prevents people from seeking help when they were part of a medical error? How can people overcome that fear so that people can more freely seek the help they need?
50:25 – Aside from research, what is the one thing RDoC can do to help our system discourage the creation of a second victim?
52:10 – What do you think is the best educational strategy to learn from failure, individually and as an organization?
53:25 – Are there limits to candour after an error beyond which further harm may occur both to the patient and the clinician or should disclosure be full and frank on all occasions?