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Advancing Relational Learning Worldwide: Disclosure and Apology

This is a self-paced, open-enrollment course that may be started and completed at any time. Please note: This course requires an updated browser to function properly. Requires Safari (v6 or higher), Chrome (v38 or higher), Internet Explorer (v11 or higher), or Firefox (v23 or higher). To check your current browser version, click here.

Disclosure and apology conversations after medical errors and adverse events are vital to safer, high quality healthcare. Transparency around errors enables organizations to learn from mistakes and take measures to prevent them from happening in the future, but these conversations are difficult for the patients, families and clinicians involved.

This course aims to support clinicians in having these difficult but necessary conversations. The course contains video materials from renowned experts in the fields of patient safety and error disclosure, as well as powerful personal stories from patients, families and providers about their experience of medical error.

This course was developed by the OPENPediatrics program at Boston Children's Hospital, and provides Continuing Medical Education credit. To access a free, non-CME version of this course, as well as hundreds of other resources on pediatric care, sign up for a free account on the OPENPediatrics site.

Cost

USD $150.00

Contributors

Dr. Robert Truog (Course Guide), Ms. Beth Daley Ullem, Dr. Elaine Meyer, Dr. Jo Shapiro, Dr. Paul Hickey, Mr. David Browning, Ms. Brenda Allair, Ms. Linda Kenney, Dr. Frederick van Pelt, Dr. Patricia Folcarelli, Mr. Mark Blazey, Dr. Kenneth Sands, Dr. Robert Wachter, Dr. Andrew Carson-Stevens, Dr. Marisa Brett, Dr. Eric Fleegler, Ms. Christine Rachwal, Dr. Stephen Brown, Dr. Elaine Meyer

Instructional Time

6 hours (including participation in the Moderated Workshop)

Course Format, Media and Technical Requirements

Self-paced, using text and video, with post-test assessments. Requires 80% or higher score to earn CME credit. Online course assessment. Requires Safari (v6 or higher), Chrome (v38 or higher), Internet Explorer (v11 or higher), or Firefox (v23 or higher).

Release/Review/Expiration Dates

Released: 11/8/2016

Reviewed: 11/8/2016

Expires: 11/8/2018

Learning Objectives

  • Describe why disclosure and apology is the right thing to do
  • Identify professional barriers to disclosure and apology
  • Recognize the emotional impacts of medical errors and adverse events on patients, families and clinicians
  • Identify the challenges and benefits of disclosure and apology conversations for patients, families and clinicians
  • Describe the TRACK core relational values for disclosure and apology
  • Apply suggested guidelines and tips for preparing for, holding and debriefing/follow up after disclosure and apology conversations
  • Describe the role and importance of disclosure coaches and use/recommend their use
  • Identify key personal and institutional steps necessary for meaningful disclosure and apology conversations
  • Recognize that the patients and families may still be angry, even if conversations go well
  • Assess approaches to disclosure and apology across the range of error cases in pediatrics
  • Evaluate whether, how and what to disclose for each case
  • Recognize the importance of support and fair resolution for both clinicians and patients
  • Examine the range of support available to clinicians across settings
  • Assess support in own setting
  • Examine the role of peer support and determine its essential features
  • Describe the features of a “just culture” for clinicians
  • Identify the sequence of errors that occurred in the example case
  • Critique the opportunities and challenges posed by technology for medical error and effective communication
  • Compare attitudes and practices on disclosure and apology in the example setting with those in own country/setting
  • Statement of Need/Target Audience

    Disclosure and apology conversations after medical errors and adverse events are vital to safer, high quality healthcare. Transparency around errors enables organizations to learn from mistakes and take measures to prevent them from happening in the future. But these conversations are difficult for patients, families and clincians involved. As a result, they often go poorly or are avoided by clinicians and institutions, leading to a so-called "disclosure gap." This course aims to support clinicians to be better prepared to have these difficult but necessary conversations. This training is helpful for:

  • MDs and Trainees
  • Pediatric MDs and Trainees
  • Accreditation/Designation Statements

    Boston Children's Hospital is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Boston Children's Hospital designates this enduring material for a maximum of 6.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Through an agreement between the American Medical Association and the European Union of Medical Specialists, physicians may convert AMA PRA Category 1 Credit™ to an equivalent number of European CME Credits® (ECMECs®). Information on the process of converting AMA PRA Category 1 Credits™ to ECMECs® can be found at: www.eaccme.eu.

    Successful completion of this CME activity, which includes participation in the activity, with individual assessments of the participant and feedback to the participant, enables the participant to earn 6.00 ABP MOC Part 2 points in the American Board of Pediatrics'(ABP), American Board of Internal Medicine (ABIM) and the American Board of Anesthesiology (ABA) Maintenance of Certification program. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABP, ABIM and ABA MOC credit.

    Instructors

    Dr. Robert Truog, MD (Course Guide)

    Frances Glessner Lee Professor of Medical Ethics, Anaesthesia, and Pediatrics, and Director, Center for Bioethics, Harvard Medical School; Executive Director, Institute for Professionalism and Ethical Practice, and Senior Associate in Critical Care Medicine, Boston Children’s Hospital

    Ms. Beth Daley Ullem, MBA

    National Patient Safety Advocate, Board Director

    Dr. Elaine Meyer, PhD, RN

    Clinical Psychologist, Boston Children’s Hospital Director, Institute for Professionalism and Ethical Practice, Associate Professor of Psychology, Harvard Medical School

    Dr. Jo Shapiro, MD, FACS

    Chief, Division of Otolaryngology in the Department of Surgery, Brigham and Women’s Hospital

    Dr. Paul Hickey, MD

    Anesthesiologist in Chief, Department of Anesthesiology, Perioperative and Pain Medicine Research, Boston Children’s Hospital

    Mr. David Browning, MSW, BCD, FT

    Co-Founder, Institute for Professionalism and Ethical Practice, Boston Children’s Hospital

    Ms. Brenda Allair, M.Ed

    Parent, Special Education Coordinator

    Ms. Linda Kenney

    Founder and Director, Medically Induced Trauma Support Services (MITSS)

    Dr. Frederick van Pelt, MD

    Associate Clinical Principal, The Chartis Group

    Dr. Patricia Folcarelli, PhD, RN

    Director of Patient Safety, Beth Israel Deaconess Medical Center

    Mr. Mark Blazey, MS, CRNA

    CRNA at Boston Children’s Hospital

    Dr. Kenneth Sands, MD, MPH

    Senior Vice President of Health Care Quality and Chief Quality Officer, Beth Israel Deaconess Medical Center

    Dr. Robert Wachter, MD

    Professor and Chief of the Division of Hospital Medicine, University of California, San Francisco School of Medicine

    Dr. Andrew Carson-Stevens, MD

    Clinical Lecturer in Health Care Improvement, Institute of Primary Care and Public Health, Cardiff University

    Dr. Marisa Brett, MD

    Associate Physician in Medicine, Assistant Professor in Pediatrics, Harvard Medical School

    Dr. Eric Fleegler, MD, MPH

    Associate Physician in Medicine, Assistant Professor of Pediatrics, Harvard Medical School

    Ms. Christine Rachwal, RN, MSN, CCRN

    Clinical Nurse Specialist, CICU, Boston Children’s Hospital

    Dr. Stephen Brown, MD

    Staff Physician in Radiology, Boston Children’s Hospital, Associate Professor of Radiology, Harvard Medical School

    Elaine Meyer, PhD, RN, for direction and development of clinical vignettes

    Director, Institute for Professionalism & Ethical Practice, Boston Children's Hospital

    Disclosures

    In accordance with the disclosure policy of Boston Children's Hospital and the standards set forth by the Accreditation Council for Continuing Medical Education, course planners, speakers and content reviewers list below any relevant relationships they or their spouse/partner have to companies producing, marketing, re-selling or distributing health care goods or services consumed by or used on patients.

    Instructor Disclosures

    No disclosures to report:

    Dr. Robert Wachter, Dr. Kenneth Sands, Dr. Andrew Carson-Stevens, Dr. Frederick van Pelt, Dr. Patricia Folcarelli, Dr. Jo Shapiro, Mr. David Browning, Mr. Mark Blazey, Dr. Robert Truog, Dr. Elaine Meyer, Dr. Paul Hickey, Ms. Beth Daley Ullem, Ms. Brenda Allair, Ms. Linda Kenney, Dr. Marisa Brett, Dr. Eric Fleegler, Ms. Christine Rachwal, Dr. Stephen Brown

    Content Reviewers

    No disclosures to report:

    Dr. Donna Luff, Ms. Lesley Niccolini, Dr. Robert Graham, Ms. Erin Ward

    Commercial and Financial Support Disclosure

    This program receives no commercial support.

    Privacy Policy

    Access the Boston Children's Hospital CME Privacy Policy here.

    1. Course Number

      BCH.IPEP001-OP
    2. Classes Start

      Apr 01, 2016
    3. Classes End

      Aug 31, 2018
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