Authors 

Professor Ian Incoll, Conjoint Professor, Faculty of Medicine and Public Health, University of Newcastle, Australia; Chair, RACS TIPS Skills Course Committee
Dr Phil Morreau, President, RACS

The 2026 revision of the Australian Open Disclosure Framework provides an opportunity to reposition open disclosure as a core professional capability within surgical education rather than a discrete risk-management activity. Compared with the 2014 framework, the revised guidance places greater emphasis on person-centred communication, restorative practice, cultural safety, psychological safety, and organisational learning following harm. Open disclosure is no longer viewed solely as the communication of adverse events but as an ongoing process aimed at restoring trust, acknowledging patient experiences, supporting healthcare professionals, and improving systems of care.

To support these objectives, surgical training programs should incorporate open disclosure longitudinally throughout the educational continuum, from medical school to specialist Fellowship and continuing professional development. Simulation-based training, as occurs in the RACS Training in Professional Skills (TIPS) course, should be used to develop skills in delivering sincere apologies, explaining complications, actively listening to patients and families, and managing emotionally challenging conversations following serious surgical adverse events. Assessment of these competencies should be incorporated into workplace-based assessments and Entrustable Professional Activities to ensure they are treated with the same importance as technical skills.

The revised framework also highlights the need for training in cultural safety, particularly in the care of Aboriginal and Torres Strait Islander peoples and encourages a restorative and “just culture” approach that prioritises learning rather than blame. 

Morbidity and mortality meetings provide an ideal setting to reinforce these principles by examining not only the clinical outcome but also the quality of communication and patient engagement following harm. Embedding these capabilities within surgical curricula will better prepare surgeons to manage complications compassionately, support patient trust, enhance clinician wellbeing, and contribute to continuous quality improvement.

In summary, the revised Australian Open Disclosure Framework signals a shift from disclosure as a medico-legal obligation to disclosure as a professional, patient-centred, and restorative practice. Surgical education must evolve accordingly by integrating structured training in communication, cultural safety, restorative practice, and systems-based learning throughout the surgical training pathway. Such an approach will equip future surgeons not only to manage adverse events effectively but also to foster trust, support healing, and strengthen the culture of safety and quality within Australian and Aotearoa New Zealand surgical practice.