The emotions experienced by family medicine residents and interns during their clinical trainings: a qualitative study (original) (raw)
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Family medicine residency training and burnout: a qualitative study
Canadian medical education journal, 2014
Almost three-quarters of family practice residents in British Columbia (BC) meet criteria for burnout. We sought to understand how burnout is perceived and experienced by family medicine residents, and to identify both contributory and protective factors for resident burnout. Two semi-structured focus groups were conducted with ten family practice residents from five distinct University of British Columbia training sites. Participants completed the Maslach Burnout Inventory (MBI). The data were analyzed using a thematic analysis approach. Seventy percent of the focus group participants met criteria for burnout using the MBI. The experience of burnout was described as physical and emotional exhaustion, loss of motivation, isolation from loved ones, and disillusionment with the medical profession. Contributory factors included high workload, burned-out colleagues, perceived undervaluing of family medicine, lack of autonomy, and inability to achieve work-life balance. Protective factor...
Medical Teacher, 2011
Background: Medical students and doctors experience several types of professional distress. Their causes (''stressors'') are commonly classified as exogenous (adapting to medical school or clinical practice) and endogenous (due to personality traits). Attempts to reduce distress have consisted of providing students with support and counseling, and improving doctors' management of work time and workload. Aim: To review the common professional stressors, suggest additional ones, and propose ways to reduce their impact. Method: Narrative review of the literature. Results and conclusion: We suggest adding two professional stressors to those already described in the literature. First, the incongruity between students' expectations and the realities of medical training and practice. Second, the inconsistencies between some aspects of medical education (e.g., its biomedical orientation) and clinical practice (e.g., high proportion of patients with psychosocial problems). The impact of these stressors may be reduced by two modifications in undergraduate medical programs. First, by identifying training-practice discrepancies, with a view of correcting them. Second, by informing medical students, both upon admission and throughout the curriculum, about the types and frequency of professional distress, with a view of creating realistic expectations, teaching students how to deal with stressors, and encouraging them to seek counseling when needed.
Medical students' emotional development in early clinical experience: a model
Advances in Health Sciences Education
Dealing with emotions is a critical feature of professional behaviour. There are no comprehensive theoretical models, however, explaining how medical students learn about emotions. We aimed to explore factors affecting their emotions and how they learn to deal with emotions in themselves and others. During a first-year nursing attachment in hospitals and nursing homes, students wrote daily about their most impressive experiences, explicitly reporting what they felt, thought, and did. In a subsequent interview, they discussed those experiences in greater detail. Following a grounded theory approach, we conducted a constant comparative analysis, collecting and then interpreting data, and allowing the interpretation to inform subsequent data collection. Impressive experiences set up tensions, which gave rise to strong emotions. We identified four 'axes' along which tensions were experienced: 'idealism versus reality', 'critical distance versus adaptation', '...
The anxieties of medical students related to clinical training
International Journal of Clinical Practice, 2006
Reflection is an important skill, as it supports both individual and lifelong learning. It can be used as a learning method in medical education for professional development at all stages. This study aims to evaluate reflective skills of third-year medical students in primary care experience. Physicians from affiliated primary health care centers supervised students during their clinical practice. Student reports was the main documents to assess learning experiences during that period. Researchers used narrative reflection in the students' reports for content analysis. Reports entries were categorized as avoidant or scant reporting, objective reporting, committed reflectors and reflectors with emotional exploration and coded accordingly. Self-learning experiences of students resulted in various levels of reflection. Students who have committed reflection and reflection with emotional exploration presented detailed and contextual information about their performances and self-learning outcomes. Some students who are categorized as objective reporters wrote simply about daily events and interactions as their learning experiences. Reflective practice provides some information about learning experiences of medical students and reflections on self-learning of primary care experience.
The Wounded Healers: a qualitative study of stress in medical students
Aim: To explore the reasons of stress in medical freshman, exploring the factors which act as stressors at entry in medical education. Methodology: Aqualitative study was conducted at Lahore Medical and Dental College, Lahore, Pakistan. Data was collected through two focus group discussions conducted with 20 first year medical students, who volunteered to be part of the study. A guide was used to assess the perceptions of participants regarding stress in their educational setting and coping strategies used by them. The interviews were transcribed verbatim and interpretative approach was used for thematic analysis of data. Data coding was done manually and scrutinized by all researchers to maximize reliability. Validity of the data was assured by sharing the interview transcripts with the participants. Results: Three main themes emerged from the focus group discussions, namely, academic burden, non-academic pressures and coping with stress. Large content of first year syllabus, greater emphasis on attendance and passing tests and time management issues were mentioned by study participants as overwhelming stressors. Other sources of stress included pressures from parents to achieve academic excellence, tensions about future, loss of confidence, mood changes and bullying by peers and teachers. Most participants tried to cope by disengagement, self-distraction and substance use. Conclusion: Freshman experiencemany academic, personal and inter-personal stressors in medical education which cause strain on their physical, psychological and social well-being. However, students are not prepared to cope with stress in a positive way.
Background: The shift from undergraduate to postgraduate education signals a new phase in a doctor's training. This study explored the resident's perspective of how the transition from undergraduate to postgraduate (PGME) training is experienced in a Family Medicine program as they first meet the reality of feeling and having the responsibility as a doctor. Methods: Qualitative methods explored resident experiences using interpretative inquiry through monthly, individual in-depth interviews with five incoming residents during the first six months of training. Focus groups were also held with residents at various stages of training to gather their reflection about their experience of the first six months. Residents were asked to describe their initial concerns, changes that occurred and the influences they attributed to those changes. Results: Residents do not begin a Family Medicine PGME program knowing what it means to be a Family Physician, but learn what it means to fulfill this role. This process involves adjusting to significant shifts in responsibility in the areas of Knowledge, Practice Management, and Relationships as they become more responsible for care outcomes. Conclusion: This study illuminated the resident perspective of how the transition is experienced. This will assist medical educators to better understand the early training experiences of residents, how these experiences contribute to consolidating their new professional identity, and how to better align teaching strategies with resident learning needs.
Medical Teacher, 2011
Background: Entering medicine for the first time is highly impressive for students, but we know little about the actual emotional learning processes taking place. Aims: We aimed to get more insight into expectations, experiences and emotions of students during their first clinical experiences in a hospital compared to a nursing home. Methods: We carried out a qualitative and a quantitative survey by administering questionnaires about expectations, impressive experiences and learning activities within two cohorts of first-year medical students before and after a 4-week nursing attachment. Results: Despite different expectations, students reported similar experiences and learning activities for the nursing home and the hospital. Most impressive events were related to patient care, being a trainee, or professional identities being challenged. Students in nursing homes most often referred to their own relationships with patients. Students expressed different emotions, and frequently experienced positive and negative emotions at the same time. Conclusions: Rewarding experiences (not only difficult or stressful events) do matter for medical professional development. Students need to learn how to deal with and feel strengthened by the emotions evoked during clinical experiences, which should be supported by educators. The nursing home and the hospital seem to be equally suited as learning environments.
Recent studies report that up to 50 percent of medical students feel burned out. Medical student burnout has significant public health consequences -as students detach, the quality of patient care is impacted, and students themselves suffer, as evidenced by the increased risk in substance use and suicide. While some theorize that medical student burnout is due to an inability to confront suffering, death, and their own mortality, this hypothesis fails to explain why preclinical students also experience burnout despite having minimal clinical exposure. /r/medicalschool, a news-aggregating website for medical students, was queried for posts from the creation of the subreddit, Dec 11, 2009 to July 1, 2018 for the term "burnout" and its grammatical variations. 352 posts and their comment threads were analyzed using a grounded theory approach. When the causes of burnout were interpreted using an existential psychodynamic framework, the predominant themes that arose were difficulties dealing with freedom (groundlessness), existential isolation, and meaninglessness, rather than death anxiety stemming from witnessing the suffering of patients. Students feel as if they are not living up to their own values of what a physician should be like and are troubled by the inconsistent values within the hidden, informal, and formal curriculum.