Obstetric sonographers’ second victim experiences following diagnostic error: implications for wellbeing, support and patient safety
Elaine Gardiner, Julie Roberts, Evelyn McElhinney, Thelma Okey-Adibe, Morgyn KayIntroduction:
Diagnostic errors in obstetric ultrasound can have devastating consequences for mothers and babies. While patients are the primary victims, healthcare professionals involved may experience psychological harm as ‘second victims’. Obstetric sonographers work in high-risk environments where diagnostic errors can occur; however, their experiences and perceptions of support are underexplored. This study investigated sonographers’ experiences following diagnostic error, focusing on perceived support.
Methods:
This qualitative study used a mixed-methods sequential explanatory design within an abductive pragmatic approach. A survey (n = 8) provided context but was limited for quantitative analysis; therefore, qualitative findings are reported. Eight obstetric sonographers with experience of diagnostic error were recruited via purposive and snowball sampling. Semi-structured interviews were conducted remotely, transcribed verbatim and analysed using reflexive thematic analysis. Rigour was enhanced through reflexivity, audit trails and supervisory review.
Findings:
Five themes were identified. Participants described experiences consistent with the second victim phenomenon, including emotional distress, loss of confidence, burnout and trauma-like symptoms. While strong professional pride was evident, high workload and emotional demands were emphasised. Unique challenges included delayed awareness of error, caring for both mother and baby and lack of opportunity for apology or closure. Peer support was valued most, while managerial and organisational support was often perceived as inadequate or procedural. Participants called for learning-orientated, just cultures.
Conclusion:
Obstetric sonographers experience substantial psychological impact following diagnostic error, shaped by emotional and organisational factors. Greater recognition and trauma-informed, learning-focused support systems are needed to promote wellbeing, patient safety and workforce sustainability.