The family asks, “How did this happen?”
The clinician must explain what is known without guessing at causes that are still under review.
Patient & FamilyOpen disclosure
Open Disclosure Simulation for Patient Safety Incidents
Practice an honest, non-defensive conversation after harm or a near-miss while making space for anger, grief, and questions that may not yet have answers.
Illustrative Moments
Common pressures learners may face
The challenge is not remembering a framework in a quiet room. It is using it when another person is worried, rushed, angry, grieving, or holding more authority.
A few of the moments from the live library - the clinical contexts below show the range.
Anger becomes an accusation
A family member uses legal or blame-focused language and the conversation risks becoming defensive.
A near-miss still changes trust
No physical harm occurred, but the patient wants to know why the event happened and what will change.
Participants
Learner and AI roles
Sometimes the room has more than one person speaking. The AI can take the roles of patients, family members, or clinical colleagues while the learner manages the communication task and interaction dynamics.
- Primary learners
- Medical students, Doctors in training, Treating clinicians
- AI partner roles
- Patient, Spouse or family member
- Performance focus
- Open and honest communication, clarity about known facts, emotional presence, and follow-up.
Framework in Practice
A disclosure conversation must distinguish honesty from speculation
Open disclosure is a transparent conversation with patients or families after a patient-safety incident. At an educational level, it includes a clear account of what is known, acknowledgment of impact, an appropriate response to emotion, and a credible follow-up path.
The clinician may face anger, grief, demands for certainty, or pressure to assign blame. They must avoid defensive language while clearly separating established facts from questions that remain under investigation.
Open disclosure
- Explain what is known in plain language
- Acknowledge the event and its impact without deflection
- Make space for emotion and questions
- Describe immediate care, review, and follow-up
Skill Goals
What learners rehearse
These goals focus on communication learners can apply in a live encounter, not a script to memorize.
- 1Open the conversation with clarity about its purpose
- 2Describe known facts in plain language without speculation
- 3Express sincere regret and acknowledge what happened and its impact without defensive deflection
- 4Respond to anger, grief, silence, and repeated questions
- 5Explain immediate remediation, systemic prevention steps, and who will follow up, when, and how
- 6Support patient rights through locally appropriate channels and information
Example Practice Scenario
A documented allergy that was missed
This illustrative moment shows the competing pressures and decisions that make the conversation educationally useful.
A patient suffered anaphylaxis after receiving penicillin despite a documented allergy in his chart. He has recovered enough to talk, and he wants to know how this happened and who is responsible.
The learner’s task: The clinician must give an honest account of what is known, acknowledge the failure and its impact, respond to pointed questions about accountability, and explain the review and follow-up that come next.
Why it is useful: The scenario makes the boundary between candor and speculation concrete. It also exposes how quickly trust can deteriorate when a clinician retreats into jargon, process language, or self-protection.
Precise, justified anger and mentions of negligenceQuestions about individual accountabilityRequests for guarantees about what happens next
Clinical Contexts
Clinical contexts learners can encounter
Illustrative contexts from the live library; institutions can prioritize existing scenarios or work with us to develop additional ones.
Surgical complication
Expected risk, unexpected outcome, and preventability may be confused in the first conversation.
Medication error
The patient needs a clear account of immediate impact and ongoing care.
Unexpected death after care
Grief and demands for explanation can arrive before all facts are available.
Family-dynamics disclosure
Several relatives may hold different information, expectations, and levels of anger.
Near-miss with no harm
The absence of injury does not remove the need for honest communication and follow-up.
Session Experience
What happens in a practice session
Browser-based practice, with no headset or special equipment required.
- 01
Live conversation
The learner speaks with AI patients, family members, or clinical colleagues who respond to the conversation as it develops.
- 02
Optional coaching in practice mode
In practice mode, learners can receive optional private coaching hints. Hints do not enter the transcript or audio, and coaching is disabled in assessment mode.
- 03
Optional self-guided debrief
The learner can reflect on the interaction and key moments before opening the performance report.
- 04
Evidence-linked feedback
The report connects feedback to what the learner actually said, while faculty can inspect the evidence behind the result.
Feedback and Faculty View
Evidence faculty can inspect
Feedback is anchored to evidence from the learner’s conversation. Consistent criteria help faculty see why a result stands and where the next debrief should focus.
Station-specific emphasis
Faculty can review candor, non-defensiveness, separation of known and unknown facts, response to emotion, and clarity of the follow-up path.
Faculty can use the report to guide a focused debrief, compare attempts, and decide where observation or coaching is needed next.
Where It Fits
Where this station fits in a training program
Use the station as communication rehearsal within a locally governed disclosure program. Faculty can connect the conversation to institutional policy, reporting processes, and jurisdiction-specific duties.
- Patient-safety and quality-improvement education
- Undergraduate and postgraduate professionalism teaching
- Hospital disclosure preparation and communication rehearsal
- AETCOM-aligned ethics and difficult-conversation modules
Important: Educational simulation only. Institutions and clinicians must follow their own open-disclosure policies, reporting requirements, and legal counsel guidance.
Questions
Frequently asked questions
Can learners practice when the investigation is incomplete?
Yes. A central learning challenge is explaining what is known, what is not yet known, and how follow-up will occur without speculating or withholding the existence of the incident.
Does the station include near-miss conversations?
Yes. Illustrative contexts include near-misses as well as incidents involving harm. The communication challenge changes, but transparency and a credible follow-up path still matter.
How should an institution use the feedback?
Faculty can review evidence from the conversation and debrief how the learner handled candor, emotion, uncertainty, and next steps. The institution should interpret performance alongside its own policy and legal guidance.
Keep Exploring
Related Patient & Family stations
Breaking Bad News (SPIKES)
Deliver difficult information clearly and respond to emotion before rushing into logistics.
Explore station
Crisis De-escalation
Reduce conversational heat while protecting safety, dignity, and professional boundaries.
Explore station
Patient Education & Teach-Back
Explain a safe plan in plain language and confirm that the patient can use it.
Explore station
Bring This Station to Your Learners
Start with a focused cohort and a real training priority
Discuss the learner group, clinical context, and faculty evidence your institution needs. Existing scenarios can be prioritized, and custom development is available with our team.