| Close to 98,000 patients die every year as a result of a medical mistake. This dissertation: (1) examined a proposed typology of competent and incompetent physician mistake disclosure styles; (2) empirically tested the mediation effect of physician mistake disclosure skills hypothesized in the PMD model; and, (3) explored potential interaction effects between physician mistake disclosure styles and mistake severity levels on medical mistake disclosure outcomes. The sample consisted of 358 undergraduate students who either reported on an actual mistake disclosure by their physician (n = 30), or were randomly assigned to severe (n = 166) and non-severe (n = 162) physician mistake disclosure scenarios with four different physician mistake disclosure styles. Exploratory factor analyses largely replicated the hypothesized factor structure of competent and incompetent physician mistake disclosure styles, with the exception of two incompetent disclosure items that loaded on different factors than hypothesized. Also, the analyses failed to discriminate among the relational and informational content dimensions of mistake disclosure competence. Furthermore, multiple regression analyses yielded two mediation effects with considerable effect sizes, suggesting that competent disclosure styles and the denial of medical mistakes mediate the relationship between fight and positive face reactions to perceived criticism with short-term mistake disclosure outcomes. Finally, analyses of variance showed consistent direct associations between competent disclosure skills and positive mistake disclosure outcomes. These findings indicate that physician mistake disclosure is an important communication construct that may help physicians cope with medical mistakes and prevent negative disclosure outcomes such as patient anger, repeated errors, and litigations in the medical field. |
