December 2012: Overcoming Adverse Events

Waking up the next morning: surgeons’ emotional reactions to adverse events. Luu S, Patel P, St-Martin L, Leung ASO, Regehr G, Murnaghan ML, Gallinger S, Moulton C. Med Educ. 2012; 46: 1179-1188. 

Adverse patient care events, defined in this article as injuries “caused by medical care rather than a disease process,” can profoundly affect practitioners, leading to many painful outcomes including “burnout, depression, guilt and shame.”^p.1180  

In this article, Luu and her colleagues present the results of interviews with surgeons in two phases; the first during which they spoke with surgeons about past events and the second during which they spoke with surgeons about recent adverse events. The results are powerful. 

As educators, we are responsible for teaching a lot of skills to residents and students in a short period of time. We teach through lecture, feedback, demonstration, and simulation. But we are not just teaching technical skills, communication tools, and professionalism. We are also teaching our learners about the profession of a doctor, a nurse, a therapist.

Baystate is continuously regarded as an exceptional teaching institution, valuing with equally high regard our current patients and our future patients. So, by giving our learners insight to our vulnerabilities – by sharing with them the ways that we navigate experiences in which we are uncertain – by doing our part to ensure that students and residents are not only mastering learning objectives but are maturing as caretakers – it is then that we also affirm our appreciation of our learners’ personal development and their emotional wellbeing.  The present article highlights the difficulty of navigating emotional responses to adverse events and, in doing so, presents a learning opportunity for students and teachers.

Bottom Line:

Adverse events can be intensely personal and emotionally troubling for practitioners. Use this article as a starting point for conversations on the difficulties associated with being the ‘second victim’ in an adverse event. Educational opportunities, including debriefing after adverse events, can provide a way for both teacher and student to navigate these times.