How Radiation Oncologists Would Disclose Errors: Results of a Survey of Radiation Oncologists and Trainees
Purpose
To analyze error disclosure attitudes of radiation
oncologists and to correlate error disclosure beliefs with
survey-assessed disclosure behavior.
Methods and Materials
With
institutional review board exemption, an anonymous online survey was
devised. An email invitation was sent to radiation oncologists (American
Society for Radiation Oncology [ASTRO] gold medal winners, program
directors and chair persons of academic institutions, and former ASTRO
lecturers) and residents. A disclosure score was calculated based on the
number or full, partial, or no disclosure responses chosen to the
vignette-based questions, and correlation was attempted with attitudes
toward error disclosure.
Results
The survey received 176
responses: 94.8% of respondents considered themselves more likely to
disclose in the setting of a serious medical error; 72.7% of respondents
did not feel it mattered who was responsible for the error in deciding
to disclose, and 3.9% felt more likely to disclose if someone else was
responsible; 38.0% of respondents felt that disclosure increased the
likelihood of a lawsuit, and 32.4% felt disclosure decreased the
likelihood of lawsuit; 71.6% of respondents felt near misses should not
be disclosed; 51.7% thought that minor errors should not be disclosed;
64.7% viewed disclosure as an opportunity for forgiveness from the
patient; and 44.6% considered the patient's level of confidence in them
to be a factor in disclosure. For a scenario that could be considerable,
a non-harmful error, 78.9% of respondents would not contact the family.
Respondents with high disclosure scores were more likely to feel that
disclosure was an opportunity for forgiveness (
P=.003) and to have never seen major medical errors (
P=.004).
Conclusions
The
surveyed radiation oncologists chose to respond with full disclosure at
a high rate, although ideal disclosure practices were not uniformly
adhered to beyond the initial decision to disclose the occurrence of the
error.
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