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      Second Victim Experiences of Health Care Learners and the Influence of the Training Environment on Postevent Adaptation

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          Abstract

          Objective

          To investigate the experience of medical and graduate learners with second victim experience (SVE) after medical errors or adverse patient outcomes, including impact on training and identification of factors that shape their postevent recovery.

          Patients and Methods

          The validated Second Victim Experience and Support Tool-Revised (SVEST-R), Physician Well-Being Index, and supplemental open-ended questions were administered to multidisciplinary health care learners between April 8, 2022, and May 30, 2022, across a large academic health institution. Open-ended responses were qualitatively analyzed for iterative themes related to impact of SVE on the training experience.

          Results

          Of the 206 survey respondents, 144 answered at least 1 open-ended question, with 62.1% (n=91) reporting at least 1 SVE. Participants discussed a wide range of SVEs and indicated that their postevent response was influenced by their training environment. Lack of support from supervisors and staff exacerbated high stress situations. Some trainees felt blamed and unsupported after a traumatic experience. Others emphasized that positive training experiences and supportive supervisors helped them grow and regain confidence. Learners described postevent processing strategies helpful to their recovery. Some, however, felt disincentivized from seeking support.

          Conclusion

          This multidisciplinary study of learners found that the training environment was influential in postevent recovery. Our findings support the need for the inclusion of education on SVEs and adaptive coping mechanisms as part of health care professional educational curriculums. Educators and health care staff may benefit from enhanced education on best practices to support trainees after stressful or traumatic patient events.

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          Most cited references36

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          Standards for reporting qualitative research: a synthesis of recommendations.

          Standards for reporting exist for many types of quantitative research, but currently none exist for the broad spectrum of qualitative research. The purpose of the present study was to formulate and define standards for reporting qualitative research while preserving the requisite flexibility to accommodate various paradigms, approaches, and methods.
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            Medical error: the second victim. The doctor who makes the mistake needs help too.

            A W Wu (2000)
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              Speaking up for patient safety by hospital-based health care professionals: a literature review

              Background Speaking up is important for patient safety, but often, health care professionals hesitate to voice concerns. Understanding the influencing factors can help to improve speaking-up behaviour and team communication. This review focused on health care professionals’ speaking-up behaviour for patient safety and aimed at (1) assessing the effectiveness of speaking up, (2) evaluating the effectiveness of speaking-up training, (3) identifying the factors influencing speaking-up behaviour, and (4) developing a model for speaking-up behaviour. Methods Five databases (PubMed, MEDLINE, CINAHL, Web of Science, and the Cochrane Library) were searched for English articles describing health care professionals’ speaking-up behaviour as well as those evaluating the relationship between speaking up and patient safety. Influencing factors were identified and then integrated into a model of voicing behaviour. Results In total, 26 studies were identified in 27 articles. Some indicated that hesitancy to speak up can be an important contributing factor in communication errors and that training can improve speaking-up behaviour. Many influencing factors were found: (1) the motivation to speak up, such as the perceived risk for patients, and the ambiguity or clarity of the clinical situation; (2) contextual factors, such as hospital administrative support, interdisciplinary policy-making, team work and relationship between other team members, and attitude of leaders/superiors; (3) individual factors, such as job satisfaction, responsibility toward patients, responsibility as professionals, confidence based on experience, communication skills, and educational background; (4) the perceived efficacy of speaking up, such as lack of impact and personal control; (5) the perceived safety of speaking up, such as fear for the responses of others and conflict and concerns over appearing incompetent; and (6) tactics and targets, such as collecting facts, showing positive intent, and selecting the person who has spoken up. Conclusions Hesitancy to speak up can be an important contributing factor to communication errors. Our model helps us to understand how health care professionals think about voicing their concerns. Further research is required to investigate the relative importance of different factors.
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                Author and article information

                Contributors
                @DrEnidRivera
                Journal
                Mayo Clin Proc Innov Qual Outcomes
                Mayo Clin Proc Innov Qual Outcomes
                Mayo Clinic Proceedings: Innovations, Quality & Outcomes
                Elsevier
                2542-4548
                24 April 2024
                June 2024
                24 April 2024
                : 8
                : 3
                : 232-240
                Affiliations
                [a ]Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL
                [b ]Biomedical Ethics Research Program, Mayo, q1Clinic, Rochester, MN
                [c ]Department of Obstetrics & Gynecology, Mayo Clinic, Rochester, MN
                [d ]Department of Nursing, Mayo Clinic, Rochester, MN
                [e ]Department of Anesthesiology and Perioperative Medicine and Healing the Emotional Lives of Peers Program, Mayo Clinic, Rochester, MN
                [f ]Division of Community and Employee Engagement, Mayo Clinic Health System–Southwest Minnesota region, Mankato, MN
                Author notes
                [] Correspondence: Address to Enid Y. Rivera-Chiauzzi, MD, 200 First Street SW, Rochester, MN 55905. Rivera-Chiauzzi.Enid@ 123456mayo.edu @DrEnidRivera
                Article
                S2542-4548(24)00014-6
                10.1016/j.mayocpiqo.2024.03.004
                11068502
                38708189
                48afe70d-be8b-401a-ac92-b9df0df02909
                © 2024 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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