World Journal of Surgery

, Volume 43, Issue 3, pp 717–722 | Cite as

Recognition and Disclosure of Medical Errors Among Residents in Surgical Specialties in a Tertiary Hospital in Ibadan

  • James A. BalogunEmail author
  • Adefisayo Adekanmbi
  • Folusho M. Balogun
Original Scientific Report



Medical error (ME) remains central to discussions regarding patient’s safety and its frequency appears high in surgical specialties because of some peculiarities. We set out to study the perception of surgical residents about medical errors, their ability to recognize them and predisposition to disclosing their errors.


This was a cross-sectional study among surgical residents at the University College Hospital, Nigeria. Data about their knowledge, perception and recognition of medical errors were obtained. Knowledge and practice of medical error disclosure was also examined. Each of these was scored on Likert scale and scores categorized. Chi-square test and logistic regression were used for analysis with p at <0.05.


92 residents participated and 11(12.0%) were females. 32.6% of the respondents had less knowledge about medical errors and these were significantly junior residents. Residents with poor perception about ME were 43.5% and recent involvement with ME was significantly associated with good perception about ME. Delay in obtaining consultation and delay in diagnosis were identified respectively as MEs by only 40(43.5%) and 31(33.7) of the participants. While 82(89.1%) agreed that all errors should be reported to the consultant, only 20(21.7%) believed patients/relatives should be informed of all errors, while 49(53.3%) were well disposed to disclosing ME. Only 4(4.3%) residents had a formal training on ME.


Knowledge of ME was low among junior residents and residents are less likely to disclose error to patients/relatives. A formal training on ME will impact on their recognition, practice, and disclosure of ME.


  1. 1.
    Leape LL, Berwick DM (2005) Five years after to err is human: what have we learned? JAMA 293:2384–2390CrossRefGoogle Scholar
  2. 2.
    Institute of Medicine Committee on Quality of Health Care in A (2000) In: Kohn LT, Corrigan JM, Donaldson MS (eds) To Err is human: building a safer health system, National Academies Press (US)Copyright 2000 by the National Academy of Sciences. All rights reserved., Washington (DC)Google Scholar
  3. 3.
    Makary MA, Daniel M (2016) Medical error-the third leading cause of death in the US. BMJ 353:i2139CrossRefGoogle Scholar
  4. 4.
    Brennan TA, Leape LL, Laird NM et al (2004) Incidence of adverse events and negligence in hospitalized patients: results of the Harvard Medical Practice Study I. 1991. Qual Saf Health Care 13:145–151 (discussion 151–142) CrossRefGoogle Scholar
  5. 5.
    Weingart SN, Mc LWR, Gibberd RW et al (2000) Epidemiology of medical error. Western J Med 172:390–393CrossRefGoogle Scholar
  6. 6.
    Grober ED, Bohnen JM (2005) Defining medical error. Can j Surg 48:39–44Google Scholar
  7. 7.
    Bosma E, Veen EJ, Roukema JA (2011) Incidence, nature and impact of error in surgery. Br J Surg 98:1654–1659CrossRefGoogle Scholar
  8. 8.
    Bari A, Khan RA, Rathore AW (2016) Medical errors; causes, consequences, emotional response and resulting behavioral change. Pak J Med Sci 32:523–528CrossRefGoogle Scholar
  9. 9.
    Balogun JA, Bramall AN, Bernstein M (2015) How surgical trainees handle catastrophic errors: a qualitative study. J Surg Educ 72:1179–1184CrossRefGoogle Scholar
  10. 10.
    Lipira LE, Gallagher TH (2014) Disclosure of adverse events and errors in surgical care: challenges and strategies for improvement. World J Surg 38:1614–1621CrossRefGoogle Scholar
  11. 11.
    Antiel RM, Blinman TA, Rentea RM et al (2016) When a surgical colleague makes an error. Pediatrics 137:e20153828CrossRefGoogle Scholar
  12. 12.
    Tevlin R, Doherty E, Traynor O (2013) Improving disclosure and management of medical error—an opportunity to transform the surgeons of tomorrow. Surgeon 11:338–343CrossRefGoogle Scholar
  13. 13.
    White AA, Gallagher TH, Krauss MJ et al (2008) The attitudes and experiences of trainees regarding disclosing medical errors to patients. Acad Med 83:250–256CrossRefGoogle Scholar
  14. 14.
    Martinez W, Lehmann LS (2013) The “hidden curriculum” and residents’ attitudes about medical error disclosure: comparison of surgical and nonsurgical residents. J Am Coll Surg 217:1145–1150CrossRefGoogle Scholar
  15. 15.
    Helo S, Moulton C-AE (2017) Complications: acknowledging, managing, and coping with human error. Transl Androl Urol 6:773–782CrossRefGoogle Scholar
  16. 16.
    Crook ED, Stellini M, Levine D et al (2004) Medical errors and the trainee: ethical concerns. Am J Med Sci 327:33–37CrossRefGoogle Scholar
  17. 17.
    Ogunleye OO, Oreagba IA, Falade C et al (2016) Medication errors among health professionals in Nigeria: a national survey. Int J Risk Saf Med 28:77–91CrossRefGoogle Scholar
  18. 18.
    Ogundiran TO, Adebamowo CA (2012) Surgeon-patient information disclosure practices in southwestern Nigeria. Med Princ Pract 21:238–243CrossRefGoogle Scholar
  19. 19.
    Ushie BA, Salami KK, Jegede AS et al (2013) Patients’ knowledge and perceived reactions to medical errors in a tertiary health facility in Nigeria. African health sciences 13:820–828Google Scholar
  20. 20.
    Rebasa P, Mora L, Luna A et al (2009) Continuous monitoring of adverse events: influence on the quality of care and the incidence of errors in general surgery. World J Surg 33:191–198CrossRefGoogle Scholar
  21. 21.
    Stone S, Bernstein M (2007) Prospective error recording in surgery: an analysis of 1108 elective neurosurgical cases. Neurosurgery 60:1075–1080 (discussion 1080–1072) CrossRefGoogle Scholar
  22. 22.
    Nishizaki Y, Shinozaki T, Kinoshita K et al (2017) Awareness of diagnostic error among japanese residents: a nationwide study. J Gen Int Med 33:445–448CrossRefGoogle Scholar
  23. 23.
    Penson RT, Svendsen SS, Chabner BA et al (2001) Medical mistakes: a workshop on personal perspectives. Oncologist 6:92–99CrossRefGoogle Scholar
  24. 24.
    Gallagher TH, Waterman AD, Garbutt JM et al (2006) US and Canadian physicians’ attitudes and experiences regarding disclosing errors to patients. Arch Intern Med 166:1605–1611CrossRefGoogle Scholar
  25. 25.
    Ghalandarpoorattar SM, Kaviani A, Asghari F (2012) Medical error disclosure: the gap between attitude and practice. Postgrad Med J 88:130–133CrossRefGoogle Scholar
  26. 26.
    Cox CL, Fritz Z (2016) Should non-disclosures be considered as morally equivalent to lies within the doctor-patient relationship? J Med Ethics 42:632–635CrossRefGoogle Scholar
  27. 27.
    Etchegaray JM, Gallagher TH, Bell SK et al (2012) Error disclosure: a new domain for safety culture assessment. BMJ Qual Saf 21:594–599CrossRefGoogle Scholar
  28. 28.
    Gallagher TH, Garbutt JM, Waterman AD et al (2006) Choosing your words carefully: how physicians would disclose harmful medical errors to patients. Arch Intern Med 166:1585–1593CrossRefGoogle Scholar
  29. 29.
    Chan DK, Gallagher TH, Reznick R et al (2005) How surgeons disclose medical errors to patients: a study using standardized patients. Surgery 138:851–858CrossRefGoogle Scholar
  30. 30.
    Martinez W, Hickson GB, Miller BM et al (2014) Role-modeling and medical error disclosure: a national survey of trainees. Acad Med 89:482–489CrossRefGoogle Scholar
  31. 31.
    Fischer MA, Mazor KM, Baril J et al (2006) Learning from mistakes. Factors that influence how students and residents learn from medical errors. J Gen Intern Med 21:419–423CrossRefGoogle Scholar
  32. 32.
    Wang AS, Eisen DB (2013) Surgical complications: disclosing adverse events and medical errors. J Am Acad Dermatol 68:144–146CrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • James A. Balogun
    • 1
    • 2
    Email author
  • Adefisayo Adekanmbi
    • 2
  • Folusho M. Balogun
    • 3
  1. 1.Division of Neurosurgery, Department of Surgery, College of MedicineUniversity of IbadanIbadanNigeria
  2. 2.Department of NeurosurgeryUniversity College HospitalIbadanNigeria
  3. 3.Institute of Child Health, College of MedicineUniversity of IbadanIbadanNigeria

Personalised recommendations