Drug Calculation Errors in Anesthesiology Residents and Faculty: An Analysis of Contributing Factors

Anesth Analg. 2019 Jun;128(6):1292-1299. doi: 10.1213/ANE.0000000000004013.

Abstract

Background: Limited data exist regarding computational drug error rates in anesthesia residents and faculty. We investigated the frequency and magnitude of computational errors in a sample of anesthesia residents and faculty.

Methods: With institutional review board approval from 7 academic institutions in the United States, a 15-question computational test was distributed during rounds. Error rates and the magnitude of the errors were analyzed according to resident versus faculty, years of practice (or residency training), duration of sleep, type of question, and institution.

Results: A total of 371 completed the test: 209 residents and 162 faculty. Both groups committed 2 errors (median value) per test, for a mean error rate of 17.0%. Twenty percent of residents and 25% of faculty scored 100% correct answers. The error rate for postgraduate year 2 residents was less than for postgraduate year 1 (P = .012). The error rate for faculty increased with years of experience, with a weak correlation (R = 0.22; P = .007). The error rates were independent of the number of hours of sleep. The error rate for percentage-type questions was greater than for rate, dose, and ratio questions (P = .001). The error rates varied with the number of operations needed to calculate the answer (P < .001). The frequency of large errors (100-fold greater or less than the correct answer) by residents was twice that of faculty. Error rates varied among institutions ranged from 12% to 22% (P = .021).

Conclusions: Anesthesiology residents and faculty erred frequently on a computational test, with junior residents and faculty with more experience committing errors more frequently. Residents committed more serious errors twice as frequently as faculty.

Publication types

  • Multicenter Study

MeSH terms

  • Anesthesia
  • Anesthesiology / education*
  • Anesthesiology / methods*
  • Anesthetics / administration & dosage*
  • Clinical Competence
  • Drug Administration Schedule*
  • Factor Analysis, Statistical
  • Faculty, Medical
  • Humans
  • Internship and Residency
  • Medication Errors / statistics & numerical data*
  • Psychometrics*
  • Reproducibility of Results
  • Risk
  • Surveys and Questionnaires
  • United States

Substances

  • Anesthetics