“If your feelings were hurt, I’m sorry…”: How Third-Year Medical Students Observe, Learn From, and Engage in Apologies

dc.contributor.authorFischer, Ian C.
dc.contributor.authorFrankel, Richard M.
dc.contributor.departmentPsychology, School of Science
dc.date.accessioned2024-08-07T16:28:29Z
dc.date.available2024-08-07T16:28:29Z
dc.date.issued2021
dc.description.abstractBackground: Apologies may play a significant role in medical care, especially in the context of patient safety, medical error disclosure, and malpractice. Studies have shown that when state laws, institutional policies, and individual skills align-including the ability to offer a sincere apology-patients and families benefit. However, little is known about how, and under what conditions, physicians offer apologies in day-to-day care. Even less is known about what medical students learn about apologies from observing their superiors in these settings. Objective: Characterize third-year medical students' experiences of observing and engaging in apologies. Design: Qualitative descriptive analysis of student professionalism narratives. Participants: Third-year medical students at Indiana University School of Medicine. Approach: A search of 7,384 unique narratives yielded 238 with apologies. A rubric based on four key elements of genuine apologies ((1) acknowledgement, (2) explanation, (3) regret/remorse, and (4) reparation) was used to classify the kind of apology offered. Apology completeness, impact, and timing were also coded. Key results: Seventeen percent of all apologies were complete (i.e., contained all four elements). Over 40% were coded as incomplete or "non-apology" apologies (i.e., those with only the first two elements). A significant relationship between apology completeness and positive student experience was found. Most apologies were offered by the attending physician or resident to patients and family members. Students were generally positive about their experiences, but one in five were coded as negative. Some students were distressed enough to offer apologies on behalf of the faculty. Apology timing did not make a significant difference in terms of student experience. Conclusions: Few education programs target apologies in the context of routine practice. With little formal instruction, students may rely on adopting what their seniors do. Faculty have an important role to play in modeling the apology process when harms-both great and small-occur.
dc.eprint.versionFinal published version
dc.identifier.citationFischer IC, Frankel RM. "If your feelings were hurt, I'm sorry…": How Third-Year Medical Students Observe, Learn From, and Engage in Apologies. J Gen Intern Med. 2021;36(5):1352-1358. doi:10.1007/s11606-020-06263-6
dc.identifier.urihttps://hdl.handle.net/1805/42699
dc.language.isoen_US
dc.publisherSpringer
dc.relation.isversionof10.1007/s11606-020-06263-6
dc.relation.journalJournal of General Internal Medicine
dc.rightsPublisher Policy
dc.sourcePMC
dc.subjectEmotions
dc.subjectMalpractice
dc.subjectMedical errors
dc.subjectMedical students
dc.title“If your feelings were hurt, I’m sorry…”: How Third-Year Medical Students Observe, Learn From, and Engage in Apologies
dc.typeArticle
ul.alternative.fulltexthttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8131483/
Files
Original bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
Fischer2021IfYour-PP.pdf
Size:
272.75 KB
Format:
Adobe Portable Document Format
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
2.04 KB
Format:
Item-specific license agreed upon to submission
Description: