An Innovative Approach for Familiarizing Surgeons with Malpractice Litigation

Yen-Yi Juo; Catherine Lewis; Christina Hanna; Howard A Reber; Areti Tillou

doi:10.1016/j.jsurg.2018.06.002

An Innovative Approach for Familiarizing Surgeons with Malpractice Litigation

J Surg Educ. 2019 Jan-Feb;76(1):127-133. doi: 10.1016/j.jsurg.2018.06.002. Epub 2018 Jul 26.

Authors

Yen-Yi Juo¹, Catherine Lewis², Christina Hanna³, Howard A Reber⁴, Areti Tillou⁵

Affiliations

¹ Center for Advanced Surgical and Interventional Technology, University of California, Los Angeles, Los Angeles, California; Department of Surgery, University of California, Los Angeles, Los Angeles, California. Electronic address: YJuo@mednet.ucla.edu.
² Department of Surgery, University of California, Los Angeles, Los Angeles, California. Electronic address: CELewis@mednet.ucla.edu.
³ Center for Advanced Surgical and Interventional Technology, University of California, Los Angeles, Los Angeles, California. Electronic address: CEHanna@mednet.ucla.edu.
⁴ Department of Surgery, University of California, Los Angeles, Los Angeles, California.
⁵ Department of Surgery, University of California, Los Angeles, Los Angeles, California. Electronic address: atillou@mednet.ucla.edu.

PMID: 30057297
DOI: 10.1016/j.jsurg.2018.06.002

Abstract

Objective: Familiarize surgery residents with medicolegal knowledge and skills required when facing the prospect of being sued through a simulation session.

Design: The general surgery residency, hospital risk management, and malpractice attorneys collaboratively organized an educational intervention, consisting of an introductory lecture followed by a mock lawsuit. Two medical malpractice attorneys acted as defense and plaintiff attorneys while an attending surgeon experienced in litigation acted as defendant. Experience, attitudes, and preintervention/postintervention competency were evaluated via retrospective self-assessment.

Setting: Weekly departmental educational conference.

Participants: Forty residents and attending surgeons.

Results: Among the participants, 27.5% had been named in a law suit before. Most surgeons (70.0%) are worried about malpractice. Physicians who had been sued were no more likely to worry about malpractice (18.6 vs 25.0%, p = 0.82) than their colleagues who had never been sued. Results from the retrospective preintervention/postintervention competency assessments demonstrated significant improvement in all measured competencies after the mock lawsuit. In comparison with attending faculty, residents obtained greater improvements in understanding the essential elements of a medical claim (1.9 vs 1.1, p = 0.03), gaining confidence doing a deposition for medical litigation (1.9 vs 0.9, p < 0.01) and understanding the do's and don'ts when named in a lawsuit (2.0 vs 1.1, p = 0.01).

Conclusions: The novel educational format effectively familiarized surgery faculty and residents with the process of litigation and improved their confidence and mental preparedness when facing the prospect of a lawsuit. It is a valuable educational tool that can be incorporated in residency training and faculty development curricula.

Keywords: Interpersonal and Communication Skills; Medical Knowledge; Medicolegal; Mock trial; Nontechnical skills; Patient Care; Practice-Based Learning and Improvement; Professionalism; Residency training; Surgery; Systems-Based Practice.

MeSH terms

Internship and Residency* / methods
Malpractice / legislation & jurisprudence*
Retrospective Studies
Specialties, Surgical / education*