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Moving from unconscious incompetence to conscious incompetence

Posted Aug 12 2012 6:27pm
I ended last week with a post about the medical school curriculum on disclosure developed by David Mayer and others at UIC.  There is a new post on Educate the Young that delves into a bit more of the pedagogical theory of the material presented.  It is the most important portion yet, and I urge you to read it, here , whether you are a medical student or someone who teaches medical students.

David explains
This post discusses the goal of bringing students a dose of reality about wanting to do right from wrong, from organization-centered to patient-centered, wanting not to "deny and defend" but tell the truth, wanting to be be caring and compassionate and not unprofessional. We talk about taking them from unconscious incompetence to conscious incompetence through simulation training using standardized patients. With his legal background, my colleague Tim McDonald made sure the students understood they shouldn't be doing this as students and residents:  It requires leadership buy-in, knowledge of hospital by-laws, support from the medical malpractice insurance carrier, knowledge of state apology laws, and coaching and mentoring before having that conversation. A bad disclosure is worse than no disclosure. Our goal was always to have them understand how we have been doing it wrong for so many years and showing them there are better ways. We also aim to have them understand that we must support our caregivers when they have not violated just culture approaches and are also hurting from the harm that they have caused.

As you read this material, you understand again why disclosure training cannot just be a fifty minute lecture .  This is sophisticated and deep stuff, worthy of attention by every medical school.
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