Wisdom through adversity: learning and growing in the wake of an error.

Abstract

OBJECTIVE: Medical errors are a nearly universal experience for physicians. An error that harms a patient is one of the most difficult experiences that physicians face. Difficult experiences can result in growth. This study investigates how physicians coped positively with having made a serious mistake. This paper describes common elements identified in how physicians coped positively with these difficult circumstances, and the positive ways in which they learned and changed. METHODS: Physicians were recruited nationally through advertisement and word of mouth. Researchers conducted in-depth interviews with 61 physicians who had made a serious medical error. Verbatim transcripts were analyzed using a grounded theory approach and constant comparative analysis methodology. RESULTS: Our analysis identified five major elements in the process of coping positively with the experience of a serious medical error. These elements included acceptance, stepping in, integration, new narrative and wisdom. Subthemes further detail the content within each element. CONCLUSION: This study provides evidence that the experience of coping with a serious mistake can be formative in a positive way for physicians and provides a "roadmap" for growth through this experience. PRACTICE IMPLICATIONS: The profession must now seek ways to foster the development of wisdom out of these difficult experiences.