Simulation education and some questions regarding future progress in Errors in Medicine.

Thu Jan 24 23:43:15 UTC 2019

Dear all,

Thanks to everyone for the excellent discussion relating to simulation teaching/education.

The following are questions that come to my mind relating to Errors in Diagnosis.

My apologies for any of the questions that seem inappropriate or off-target. I am well-retired from medicine and am not in touch with as many things as I would like to be.

I have been a member of the NPSF and then the SIDM list serves for over 20 years. 
It seems that we debate constantly but little seems to happen in terms of reducing patient deaths and injury.
Also, we do not know accurately if deaths due to errors are increasing, static or decreasing. Speculation says they are increasing.
Are we currently saving lives and reducing injury with our endeavors - if not, why not?

I have assumed that the discussions on the SIDM list serve roughly give the flavor of what is transpiring within SIDM.
Is the current overall progress SIDM is making in diagnostic errors satisfactory?
Do we fully understand the relationship of diagnostic errors and all the other errors in medicine?
Do the SIDM Mission and Goals change with time?
Are the Goals time related?
On its web site SIDM states, "The Society to Improve Diagnosis in Medicine (SIDM) catalyzes and leads change to improve diagnosis and eliminate harm from diagnostic error.”
Does this need revisiting in any way?

To what extent do national politics hinder what we would like to do?
What is the best way to handle national issues so that we make progress?

Do we need more creativity to solve all the various problems?
Are individuals or small groups of people more likely to be creative?
Would <> or a similar site work well for SIDM to enhance creativity?
What is the role of simulation training in medicine? Where is that learning strategy going in medicine?
What monies does SIDM need to obtain to enhance a robust research endeavor? 
Would defined clinical studies be a way forward? Studies that show a reduction in deaths are more likely to be accepted by the medical profession.
Does the SIDM Coalition hinder or promote a reduction of errors in diagnosis?

Is the task of dealing with errors in diagnosis as one task too large?
Would it be better to divide the whole into parts and assign people to handle the various parts? For example, history and physical, laboratory testing, radiological testing, biases, and differentials.
Could these units/parts become somewhat competitive with Oscar-like awards every two years? If so what are the next steps?

Do biases because, of employment, other loyalties, and ideological philosophy, etc. hinder progress in diagnostic error prevention?

Trusting that there are not too many questions here - and thank you for reading this far!

Robert Bell, M.D.

Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine

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