When facing our fallibility constitutes "safe practice": Further evidence for the Medical Error Disclosure Competence (MEDC) guidelines.

Abstract

This study pursues further empirical validation of the "Medical Error Disclosure Competence (MEDC)" guidelines. The following research questions are addressed: (1) What communicative skills predict patients' perceived disclosure adequacy? (2) To what extent do patients' adequacy perceptions predict disclosure effectiveness? (3) Are there any significant sex differences in the MEDC constructs? A sample of 193 respondents completed an online survey about a medical error they experienced in the past 5 years, and about the subsequent disclosure of that error to them. One in four patients had experienced a medical error, only a third of them received a disclosure. Only interpersonal adaptability influenced disclosure adequacy, with a large effect size. Adequacy, in turn, predicted both patients' relational distancing and approach behaviors. Nonverbally skillful disclosures significantly decreased the likelihood of patient trauma. Expressions of remorse significantly increased patient resilience. Nonverbal skills (-) and a full account (+) predicted patients' tendency to harm themselves. Males were more reactive to disclosures than female patients. MEDC guidelines-adherent disclosure communication maintains the provider-patient relationship, increase patient resilience, and decreases patient trauma after a medical error. Given the results of this study, adherence to the MEDC-guidelines must be considered "safe practice."