• Pål Morten Engelsen Paulsen and Guttorm Brattebø.
• Akuttmedisinsk seksjon, Kirurgisk serviceklinikk, Haukeland Universitetssjukehus, 5021 Bergen.
• Tidsskr. Nor. Laegeforen. 2006 Aug 24; 126 (16): 2129-32.

BackgroundAs health care providers most of us will experience that patients are harmed by medical treatment. Our attitudes and reactions to this part of the medical reality are therefore important.Material And Methods103 medical students and 156 hospital doctors (surgeons and anaesthetists) at a university hospital were asked to answer a questionnaire anonymously.Results81 students (80 %) and 69 hospital doctors (44 %) responded. Students were more worried about the possibility of harming patients, and 78 % of the students had considered dropping out because of this. 88 % of the doctors answered that they had done mistakes that could have had consequences and 71 % answered that they had done mistakes that had consequences. If an error does not cause harm, both students and doctors were reluctant to share the event with others. Doctors were less interested in placing guilt than students. When the error had caused harm, the students were less willing than the doctors to inform others, including the patient. The doctors are sure that they themselves will support and help a colleague who tells them about an error, but they did not think that their department had a system to handle situations like that.InterpretationTo be able to learn from errors, it is important to consider all adverse events, also those that do not cause patient injury. It is important that health care workers understand why they should report, that the actual reporting is perceived as a positive experience and that it feels safe to do so. Supporting health care workers after errors and patient harm is vital to keep the caregivers in work. There are still areas for improvement before a just culture combined with sound error management is achieved. Medical students need more knowledge about patient safety.

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