OET Rx - Lesson 27: Managing and Disclosing Medical Errors
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OET Rx

Lesson 27: Managing and Disclosing Medical Errors

Course Progress: Lesson 27 of 100

In this lesson, you will be able to:

  • Understand the ethical and professional duty to be open and honest when a medical error occurs.
  • Use a structured approach to disclose an error, including offering a sincere apology.
  • Explain the facts of what happened without using defensive language or jargon.
  • Describe the steps being taken to mitigate harm and prevent recurrence.

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Watermark: Persia Global

Part 1: Lesson Objectives

By the end of this lesson, you will be able to:

  • Understand the ethical and professional duty to be open and honest when a medical error occurs.
  • Use a structured approach to disclose an error, including offering a sincere apology.
  • Explain the facts of what happened without using defensive language or jargon.
  • Describe the steps being taken to mitigate harm and prevent recurrence.

Part 2: Vocabulary & Examples

General Vocabulary

much /mʌtʃ/:

زیاد

I understand that this news will cause you much distress, and I am here to answer all of your questions.

muscle /ˈmʌsl/:

عضله

During the procedure, a muscle was inadvertently bruised, which is causing the post-operative pain you are feeling.

must /mʌst/:

باید

It is our professional duty, and we must be open and honest with you about what happened.

myself /maɪˈself/:

خودم

As the lead surgeon, I, myself, take full responsibility for the outcome of your operation.

name /neɪm/:

نام

Before I begin, can you please confirm your full name and date of birth for me?

narrative /ˈnærətɪv/:

روایت

It is important that we establish a clear factual narrative of the events that led to this adverse outcome.

narrow /ˈnæroʊ/:

محدود کردن

Let's narrow our focus to what happened, what we are doing about it now, and what we will do to prevent it from happening again.

natural /ˈnætʃrəl/:

طبیعی

It is a natural human response to feel angry and upset in this situation.

naturally /ˈnætʃrəli/:

به طور طبیعی

You will naturally have many questions, and I am here to answer them as honestly as I can.

nature /ˈneɪtʃər/:

ماهیت

Given the serious nature of this incident, a full root cause analysis will be conducted.

nearly /ˈnɪəli/:

تقریبا

We have nearly completed our initial investigation into why the wrong dosage was administered.

necessarily /ˌnesəˈserəli/:

الزاما

This adverse outcome is not necessarily the result of an error, but it is an unexpected complication that we must discuss.

necessary /ˈnesəsəri/:

ضروری

It is necessary to inform you of this error, even though no harm has occurred as a result.

nerve /nɜːrv/:

عصب

I am very sorry to report that a small sensory nerve was bruised during the surgery.

nervous /ˈnɜːvəs/:

عصبی، نگران

It's understandable to feel nervous about your future care, so let me explain the steps we are taking to ensure your safety.

nevertheless /ˌnevəðəˈles/:

با این وجود

The error was caught before the medication was administered; nevertheless, we are treating this as a serious incident.

new /njuː/:

جدید

We are implementing a new checking system to ensure this type of error cannot happen again.

news /njuːz/:

خبر

I have some difficult news to discuss with you regarding the procedure yesterday.

Medical Vocabulary

Accountability /əˌkaʊntəˈbɪləti/:

پاسخگویی، مسئولیت‌پذیری

Taking accountability means acknowledging the error and focusing on learning from it.

Adverse Outcome /ˈædvɜːs ˈaʊtkʌm/:

پیامد نامطلوب

While the surgery was performed correctly, a known but rare complication occurred, leading to an adverse outcome.

Apology /əˈpɒlədʒi/:

عذرخواهی

A sincere apology is the first and most crucial step in disclosing a medical error to a patient.

Disclosure /dɪsˈkloʊʒər/:

افشاگری

Open disclosure of medical errors is a fundamental ethical duty and is essential for maintaining patient trust.

Duty of Candour /ˈdjuːti əv ˈkændər/:

وظیفه صداقت

Our hospital has a strict Duty of Candour policy, which means we must inform you fully about what has happened.

Incident Report /ˈɪnsɪdənt rɪˈpɔːrt/:

گزارش حادثه

I have completed an incident report to ensure that the entire system can learn from this mistake.

Medical Error /ˈmedɪkl ˈerər/:

خطای پزشکی

Prescribing a medication to a patient with a known allergy is a serious medical error.

Mitigation /ˌmɪtɪˈɡeɪʃn/:

کاهش، تسکین

Our immediate focus was on the mitigation of any potential harm caused by the error.

Near Miss /nɪər mɪs/:

خطای منجر به آسیب نشده

The pharmacist caught the prescribing error before the drug was dispensed; this is classified as a "near miss".

Root Cause Analysis /ruːt kɔːz əˈnæləsɪs/:

تحلیل ریشه‌ای علت

A root cause analysis revealed that the error was due to a systemic issue, not just an individual's mistake.

Part 3: Pre-Class Practice Tests

Reading Task (Longer & More Professional):

Excerpt from The Journal of Patient Safety and Risk Management

Title: The Professional Duty of Candour: Beyond the Apology

The implementation of a statutory Duty of Candour in many healthcare systems has fundamentally shifted the professional approach to medical errors. Historically, a culture of defensiveness and non-disclosure often prevailed, driven by fears of litigation. However, modern medical ethics, supported by a growing body of evidence, recognizes that transparency is paramount for maintaining patient trust and improving systemic safety. The Duty of Candour is not merely about offering an apology; it is a holistic process of open and honest communication.

The process requires several distinct components. The first is a prompt and sincere apology for the harm and distress caused. This should be an expression of regret, not necessarily an admission of legal liability. The second, and arguably most crucial, component is a factual explanation of what happened and why, presented in layman's terms. Patients consistently report that understanding the "why" is a key part of their ability to process the event. This naturally leads to a discussion of the short- and long-term consequences of the error for the patient's health.

Finally, a robust disclosure conversation must include an explanation of the steps being taken to prevent recurrence. This demonstrates accountability and shows the patient that their negative experience will be used as a catalyst for improvement. Informing the patient that a full investigation, such as a Root Cause Analysis, will be conducted and that its findings will be shared with them can be a powerful step in rebuilding trust. This transforms the event from a personal tragedy into an opportunity for systemic learning, which is the ultimate goal of any patient safety framework.

Question: In addition to a sincere apology, what does the author identify as a crucial component of the disclosure process for patients?

Listening Task (Part B Simulation):

Scenario: You will hear two hospital managers, Sarah and David, discussing a recent incident report.

0:00

Task: What is the primary focus of their discussion?

Part 4: Answer Key for Pre-Class Work

Reading Answer: b) A detailed, factual explanation of why the error occurred.

Listening Answer: c) Understanding the systemic reasons for the error to prevent it from happening again.

Part 5: In-Class Preparation

This section is designed specifically for doctors. Be prepared to discuss the vocabulary and practice the following tasks in class.

Speaking Task: OET Role-Play Card (Medicine)

Setting: A private room on a surgical ward.

Patient: A 60-year-old patient who you operated on yesterday for a hernia repair. During the procedure, a small nerve was bruised, a known but rare complication. The patient now has some temporary numbness on their inner thigh.

Task:

  1. Sit down with the patient.
  2. Explain that you have some difficult news about an unexpected outcome from the surgery.
  3. Clearly and factually explain what happened (e.g., "During the operation, a small skin nerve was bruised, which has led to this patch of numbness.").
  4. Offer a sincere apology for this unexpected outcome and the worry it is causing.
  5. Explain the prognosis (e.g., the feeling is expected to return gradually over a few months).
  6. Outline the plan for mitigation and follow-up.

Writing Task:

You are the surgeon from the speaking scenario. After your conversation with the patient, you must complete a formal incident report. Write a concise, factual summary of the event. Include what happened, the patient's current condition (the neurological deficit), the fact that you have disclosed the event to the patient, and the follow-up plan.