Diagnostic error, quality assurance, and medical malpractice/risk management education in emergency medicine residency training programs

Diagnosis (Berl). 2019 Jun 26;6(2):173-178. doi: 10.1515/dx-2018-0079.


Background Diagnostic errors in emergency medicine (EM) can lead to patient harm as well as potential malpractice claims and quality assurance (QA) reviews. It is therefore essential that these topics are part of the core education of trainees. The methods training programs use to educate residents on these topics are unknown. The goal of this study was to identify the current methods used to teach EM residents about diagnostic errors, QA, and malpractice/risk management and determine the amount of educational teaching time EM programs dedicate to these topics. Methods An 11-item questionnaire pertaining to resident education on diagnostic errors, QA, and malpractice was sent through the Council of Emergency Medicine Residency Directors (CORD) listserv. Differences in the proportions of responses by duration of training program were analyzed using chi-squared or Fisher's exact tests. Results Fifty-four percent (91/168) of the EM programs responded. There was no difference in prevalence of formal education on these topics among 3- and 4-year programs. The majority of programs (59.5%) offer fewer than 4 h per year of additional QA education beyond morbidity and mortality rounds; a minority of the programs (18.8%) offer more than 4 h per year of medical malpractice/risk management education. Conclusions This needs assessment demonstrated that there is a lack of dedicated educational time devoted to these topics. A more formalized and standard curricular approach with increased time allotment may enhance EM resident education about diagnostic errors, QA, and malpractice/risk management.

Keywords: diagnostic error; malpractice; quality assurance; resident education; risk management.

MeSH terms

  • Curriculum
  • Diagnostic Errors / prevention & control*
  • Education, Medical, Graduate
  • Emergency Medicine / education*
  • Humans
  • Internship and Residency*
  • Malpractice*
  • Quality Assurance, Health Care*
  • Risk Management*
  • Surveys and Questionnaires