“Hey Daniel, greetings from Jack [our attending, name changed]: Don’t ever put in a pneumocath in a patient’s chest again, your patient suffered a pneumothorax”.

That’s how I was greeted to my late shift after I had put a chest tube in a patient the day before, which obviously hadn’t work out as we had hoped.

As it turned out, the patient had a pneumothorax before I even saw him. But either way, I wasn’t all that happy about this kind of feedback in front of all my colleagues. Obviously someone was happy I had caused a complication. In my last post I pointed out that we have to bring our colleagues mistakes to our attention. While that sounds logical it can be really challenging.

Nobody likes to talk about his mistakes, so many people will react defensive or even angry.

Here are my 7 steps to give honest feedback to my colleagues.

1. Ask yourself how you would like to be confronted with your own mistakes

   I would want to know about them, but in a respectful and non-judgmental manner. It should be in a non-ironic, upfront, non-preachy way. I’d prefer a private conversation without other colleagues or attendings around, if possible.

2. Bring the situation back to your colleagues mind.

   The main goal is that the colleague will recall the patient and knows that the patient took a different course than he expected. It’s not your job to educate him. (obviously if he is your student, resident or fellow, you are allowed to kick his butt)

3. Share a mistake of your own:

   A great way to create an atmosphere where you can talk about mistakes is admitting one of your own. If you share a similar mistake of your own in the past, it makes it easier for your colleague to admit his own.

4. Refrain from recommendations…

   …on how to act the next time or which books he should read to avoid this mistake in the future. That’s all up to him.

5. Be prepared that he will not realize it at first.

   That’s OK. Your job is done. He’ll want to have another look at the lab values, the x-rays and analyse where and why he went wrong. Let him do that, give him the chance to call the patient and the situation back to his mind.

6. Do not to blame him.

   It’s not judgement day. You are just trying to make a point here. Talk about how other people reacted (“Dr. XYZ was so mad at you, when he heard what you did”) ONLY if it’s relevant.

   Most of the time it’s irrelevant and more gossip than anything else. On the other hand you have to prepare him if his boss showed any kind of reaction so your colleague gets a chance to justify himself or apologise.

7. Remember you are doing all this for his own sake.

   You’re giving him a chance to learn something and even though he may be mad at you at first, it’s the right thing to do.

Question: How do you like to be told about your error? Please leave a comment!