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August 9, 1995

Error in Medicine-Reply

Author Affiliations

Massachusetts General Hospital Boston

JAMA. 1995;274(6):461. doi:10.1001/jama.1995.03530060031026

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In Reply.  —The letters from Dr Bell, Dr Cunnington, Dr Fetters, and Mr Shaw-Taylor make a series of helpful additions to Dr Leape's article and my accompanying Editorial. However, in particular comments, they illustrate how easy it is to lose sight of the forest for the trees when the subject is prevention of error in medicine. As Bell points out, the conditions under which physicians-in-training work may be conducive to medical error, and systems of medical education could almost certainly be redesigned in ways that reduce medical error. However, the process of doing so should be methodical and scientific, and it should take advantage of all available information from nonmedical and medical disciplines on how such training should proceed. One wonders, for example, whether the use of flight simulators to minimize pilot error would have some analogous application in medical training. The essential insight is to see training as a

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