Dealing with ‘mistakes’

• February 10, 2025
• Esther Waterhouse

When improv performers are on stage, building something collaboratively in the moment, ‘mistakes’ happen.  Perhaps a character’s name is forgotten, or changed; maybe two characters get given the same name, maybe one player forgets a part of the story that has been built.  The audience can see this (and delights in it) and the only way forward is to acknowledge the ‘mistake’ and build it into the story.  I have seen whole shows built on the fact that two characters have the same name, a show where a convenient tunnel from Lake Erie to the Pacific was created so that a submarine could get from the ocean to its lakeside base (which was named as the base by mistake!), and a story where one character moved between names.  All the ‘mistakes’ created delightful opportunities to play with the other players and the audience.

In contrast, in healthcare there has long been an avoidance of owning up to errors.  People worry about getting blamed, or judged, or disciplined.  This culture has made people wary of declaring low harm errors (or even near misses) which then makes it more difficult to prevent harm from happening. We now have both professional and statutory duty of candour in medicine in the UK, and we know that the first thing to do when we make a mistake is to admit it – and yet we still struggle to admit mistakes openly.

How can we marry a culture where mistakes are visible, celebrated and used to create opportunity with a culture where, too often, mistakes are hidden or used for judgement?  In a medical improv session we spend a lot of time talking about ‘mistakes’ and encouraging a new way of dealing with them.  We encourage a celebration of error – in class we will often all shout ‘yay’ when something goes wrong.  In clinical practice we would recommend acknowledging the error, both internally and to others, so that people can learn from the error and hopefully prevent it happening again.

A simple example.  I struggle at times with names, and recently addressed an unconscious woman by the wrong first name.  I quickly corrected myself and addressed her correctly.  Before doing improv, I might have hoped that no-one had noticed..  Now that I have a different mindset, when I left the bedside I acknowledged the error to the team – ‘did you notice that I got the patient’s name wrong?’ and then stated a way to try to prevent that happening again – ‘This reminds me to check the name before I enter the bedspace’.  

It sounds simple doesn’t it?  So simple, and yet we rarely do it.  We feel embarrassed and judge ourselves (‘I should have got that name right’) as well as worrying about the judgement of others (‘I hope no-one noticed that I made that silly mistake’).  And by so doing we lose the opportunity to learn.

Come on one of our study days – where we celebrate ‘mistakes’ – and try a new way of dealing with error.