| Abstract [eng] |
According to world statistic, errors in medicine (EM) are very common. The price of them is often a burden of the health care system. Errors make a negative image of doctors and is a threat for partneships between doctors and patients. However, more than half of EM can be avoided. The situation on EM is not known in Lithuania, because there is no any studies on this. Aim: To investigate knowledge and opinion about the error in medicine among medical students and residents. Methods: medical students and residents were selected by convenience sampling method from RVUL and VUL SK hospitals in 2011 Sep - Dec. Cronbach alpha of questionnaire - 0.72. 250 questionnaires were used in statistical analysis. Student's, Mann Whitney and Kruskal Wallis tests were used to compare unpaired samples. Spearman's correlation and Cramer's V coefficients were used to determine relations between variables. A binary logistic regression (Nagelkerkes coefficient of determination (R2)) was used to determine how the tied variable - approval or disapproval – depends from respondent's sex and status (student/resident). The statistical significance level p ≤ 0.05. Results: The study sample consisted of 165 medical students (66.0%) and 85 residents (34.0%). Students’ average age 23.3±0.9 years, residents’ - 28.0±2.2 years. The vast majority of respondents (40.0%) their theoretical knowledge of EM assessed moderately. It was found that the status and sex almost did not affect their knowledge (R2=0.022, R2=0.061). Students and residents totally agreed that the most important factors, which influence EM are teamwork (p=0.95), stress (p=0.14), fatigue (p=0.14), workload (p=0.26), practical skills (p=0.58). However, more women than men agreed on those the most important factors. It was found that sex almost did not affect the choice of the most important factors of EM (R2 0.053-0.072). 41.2% students and 27.1% of residents did not know whether the error registration system could reduce the EM number (p=0.03). More students than residents disagreed that Lithuanian health care system is safe for patients today (31.8% and 15.2%, respectively, p=0.002), and that it would be difficult to report colleagues about EM (34.1%, and 20,0% respectively, p=0.01). However, more residents than students totally agreed that recognition and analysis of EM is an important part of doctors’ job (34.1% and 21.2% respectively, p=0.03). When respondents make an error, the vast majority of women (54.2%) first, apologize and inform the patient about this, but the majority of men (51.7%) first, inform his manager (p=0.02). Students (53.9%) and residents (49.4%) behavior would be the same, respectively (p=0.001). If respondents will make an error, more women than men totally agreed that they will be affraid of being punished (26.8% and 15.0%, respectively, p=0.001, R2=0.061), feel guilty (52.6% and 25.0%, respectively; p=0.001, R2=0.064) and survive due to its failure (51.6% and 31.7%, respectively, p=0.003). However, among students and residents there were no differences (p=0.053, R2=0.023), (p =0.79) and (p=0.55), respectively. Conclusions: the majority of respondents their own knowledge of EM assessed moderately. Students their own theoretical knowledge of EM assessed worse than residents, women worse than men. More women than men believed that the most important factor of EM were workload, practical skills, fatigue, stress, and teamwork. The vast majority of residents if made an error first of all inform his manager, and student contrary - first apologize and inform the patient about fails. Almost all respondents if made an error feel guilt and fear. |
