“I made a mistake!”: a narrative analysis of experienced physicians’
stories of preventable error
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.