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Individual and Team-Based Medical Error Disclosure: Dialectical Tensions Among Health Care Providers

Mandy Jones, Jennifer Scarduzio, Elzaba Mathews, Paula Holbrook, Darlene Welsh, Lee Wilbur, Douglas Carr, L Curtis Cary, Christopher I Doty, James A Ballard
Qualitative Health Research 2019 April 8, : 1049732319837224
Researchers from disciplines of education, health communication, law and risk management, medicine, nursing, and pharmacy examined communication tensions among interprofessional (IP) health care providers regarding medical error disclosure utilizing patient simulation. Using relational dialectics theory, we examined how communication tensions manifested in both individual-provided medical error disclosure and IP team-based disclosure. Two dialectical tensions that health care providers experienced in disclosure conversations were identified: (a) leadership and support, and (b) transparency and protectionism. Whereas these tensions were identified in an IP education setting using simulation, findings support the need for future research in clinical practice, which may inform best practices for various disclosure models. Identifying dialectical tensions in disclosure conversations may enable health communication experts to effectively engage health care providers, risk management, and patient care teams in terms of support and education related to communicating about medical errors.


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