Mamede et al studied internal medicine residents who were given written cases to solve. Some of the cases contained salient distracting clinical features, or “red herrings”, such as a family history of tuberculosis inserted into a typical case of celiac disease. These distracting features decreased the proportion of correct diagnoses in all types of cases; this effect was statistically significant in the subgroup of complex cases in which the distracting feature occurred early in the case summary. Sukalich et al studied first-year residents who practiced disclosing a nursing error to a standardized family member. Residents participated in the same simulation about one month later. In between the two sessions, they had viewed a recording of their first interaction and participated in a 15-minute on-line tutorial about error disclosure. Both resident self-evaluations and blinded observers of the simulations noted modest improvement between the first and second session. –Laura Willett, MD
Mamede S, van Gog T, van den Berge K, van Saase JL, Schmidt HG. Why Do Doctors Make Mistakes? A Study of the Role of Salient Distracting Clinical Features. Acad Med. 2013 Nov 25.
Sukalich S, Elliott JO, Ruffner G. Teaching Medical Error Disclosure to Residents Using Patient-Centered Simulation Training. Acad Med. 2013 Nov 25.