HOW HOUSE OFFICERS COPE WITH THEIR MISTAKES

We examined how house officers coped with serious medical mistakes to gain insight into how medical educators should handle these situations . An anonymous questionnaire was mailed to 254 house officers in inter nal medicine asking them to describe their most important mistake and their response to it; 45% (N = 114) reported a mistake and completed t he questionnaire. House officers experienced considerable emotional di stress in response to their mistakes and used a variety of strategies to cope. In multivariate analysis, those who coped by accepting respon sibility were more likely to make constructive changes in practice, bu t to experience more emotional distress. House officers who coped by e scape-avoidance were more likely to report defensive changes in practi ce. For house officers who have made a mistake, we suggest that medica l educators provide specific advice about preventing a recurrence of t he mistake, provide emotional support, and help them understand that d istress is an expected concomitant of learning from the experience.