Systems errors versus physicians' errors: finding the balance in medical education.
The movement to systems thinking as a mechanism to reduce errors poses unique challenges in academic medical centers. This article illustrates the need to balance the systems approach to error prevention with the valuable educational opportunities for training physicians when personal errors occur. Discussion suggests that if physicians rely on searching only for systems solutions, the important process of modifying future behaviors will be lost. The authors offer a number of solutions, which include active efforts by training programs to foster optimal learning environments and avoid reinforcement of blame, fear, and inadequacy. Role modeling, an essential part of every teaching hospital, must not only support disclosure of error but also demonstrate the importance of personal responsibility. This article is a useful reminder to educators in their efforts to train physicians for the future.