Many factors inhibit clinicians from disclosing medical errors to patients, ranging from inadequate training in error disclosure, fear of precipitating a malpractice lawsuit, and sometimes explicit discouragement of disclosure. This article draws a sharp contrast between the traditional "deny and defend" approach to error disclosure, and the "disclose and apologize" model that has been successfully implemented at some institutions. Based on survey data, the authors argue that formal error disclosure training programs for staff not only teach important skills, but promote a values-based work environment. Health care leaders, in their view, should adopt "disclose and apologize" policies, and train employees to disclose and discuss errors as a key part of improving organizational safety culture.