Students' Perceptions of Trigger Warnings in Medical Education (original) (raw)
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According to the popular press, students have been increasingly demanding warnings before being exposed to potentially distressing classroom material. The validity of these types of trigger warnings has been a topic of vigorous debate. Based on a review of posttraumatic stress disorder (PTSD) research and closely related topics, this article answers questions that teachers might ask about the validity of the scientific assumptions behind trigger warnings and their use in the classroom. External stimuli causing distress is a feature common to many mental disorders, and trauma-based triggers of distress are an essential feature of PTSD. However, development of PTSD after a traumatic experience is relatively rare. Environmental triggers are often difficult to predict, but warnings may reduce distress among people with PTSD by allowing exposure to be controlled. To the extent that trigger warnings allow avoidance of hyperarousal when trying to learn, they should increase students' classroom performance. However, avoidance of trauma reminders contributes to the persistence of PTSD symptoms. Although clinical research generally supports the notion of trigger warnings as an accommodation for individual students diagnosed with PTSD, the effectiveness of trigger warnings in the classroom is unknown. In addition, trigger warnings may be a legitimate accommodation for students with psychiatric disabilities, but this does not mean that they are relevant to nonclinical issues.
Trigger Warnings: Caring or Coddling
The Australian and New Zealand Student Services Association, 2017
Trigger warnings are proposed as a strategy to keep university students safe from potentially distressing material. While used internationally for several years, they have begun to be formally implemented in some Australian universities. This paper provides a critical review of the underlying theoretical premises of trigger warnings and the personal and professional impact of such warnings for students in health professions. As with most short-term avoidance strategies, trigger warnings are likely to have a negative impact on student mental health, rather than improve it. The warnings undermine the autonomy and selfmanagement skills of students as independent, adult learners. If these warnings become more widespread, they have significant implications for the resilience of students. For students in health professions, who need skills to manage a wide-range of often unpleasant topics and provide responsive and competent treatment for their patients, they have the potential to result in adverse outcomes in patient care. The development of coping skills to flexibly self-manage and self-regulate emotions and behaviour is an important graduate attribute and provides an alternative to counterproductive trigger warnings.
Instructors' Use of Trigger Warnings and Behavior Warnings in Abnormal Psychology
College students have been increasingly demanding warnings and accommodations in relation to course topics they believe will elicit strong, negative emotions. These ''trigger warnings'' are highly relevant to Abnormal Psychology because of the sensitive topics covered in the course (e.g., suicide, trauma, sex). A survey of Abnormal Psychology instructors (N ¼ 131) indicated that the majority of them regularly warned students to avoid course-specific behaviors such as stigmatizing mental illness, diagnosing people they know, and sharing personal information. In contrast, the majority of instructors did not provide regular warnings over the course topics that might trigger students, and most instructors had neutral or negative opinions about trigger warnings. Overall, the results suggest that most Abnormal Psychology instructors do not view trigger warnings as essential to the teaching of sensitive topics.
The academically destructive nature of trigger warnings
First Amendment Studies, 2016
Trigger warnings are the latest concession to the notion espoused by some students and progressive professors that learning, particularly in higher education, should be pain-free psychologically. Such a premise is antithetical to the values of academic freedom and the marketplace of ideas and is inconsistent with students' learning and confronting ideas with which they are unfamiliar and which are outside of their comfort zone. Yielding to demands for trigger warnings when exposing students to ideas, topics and exchanges that may become uncomfortable negates growth for students. In short, acquiescing to the self-serving demands for trigger warnings makes education nothing but the reaffirming of ideas and positions with which students enter the academy. This article may upset undergraduates and progressive faculty and administrators…deal with it.
Canadian Medical Education Journal
For decades there has been ample evidence that training to become a physician and practicing medicine is hazardous to one’s health and wellness. In the face of the extremely high rates of suicide, substance abuse, depression and burnout in the medical student, resident, and physician populations, it would be dishonest to suggest medical education and practice is all gain and no pain. This article is directed to members of the medical education community and challenges stakeholders to view their teaching and training of medical students as an intervention requiring free and informed consent. We hope this exercise shifts the paradigm of educators and enables students to enter medical training from a free and informed position.
Class Room to Real Life: Medical Students Perception and Barriers regarding Breaking Bad News
The objective of this study was to assess the perception, skills and comfort level of medical students in clinical years regarding breaking bad news and perceived attainment of objectives in communication skills module. This is a survey using quasi-experimental (pre-/post-intervention) study design. All students in the final year at OMC, consented to participate were included in the study. Questionnaires were provided prior and post-workshop. The commonly used 6-point SPIKES protocol for breaking bad news was discussed. Questionnaire was mainly comprised of demographic details, pre and post questions, any previous training in communication skills, whether they had observed bad news being broken by a senior, how stressful they thought BBN was to them and SPIKES protocol, confidence levels among participants in communicating bad new and barriers of breaking bad news. Statistical analysis was performed using SPSS 20.v. Data were expressed in frequencies, mean and percentages, t test and man Whitney U test were used to evaluate the significant differences between pre and post responses. A total of 70 medical students were participated in the study in which 60 (85.7%) were female participants. Significant statistical difference was observed between pre and post response of participants involving communicating bad news (p-0.025). Similarly, there was a significant difference in the responses of participants aged <25 and ≥ 25 years responses regarding communicating bad news (p < 0.001). This study results revealed that at pre workshop, participants had statistically significantly (p-0.006, 95% CI-15.08-2.63) low pre-workshop score compared to post-workshop responses. Similarly, statistical difference was observed between age > 25 and <25 years old participants (p-0.027, 95% CI-1.19-19.13). No significant difference was found between male and female participant's responses (p-0. 927, 95% CI-9.03-8.22).
When Bad Things Happen: Training Medical Students to Anticipate the Aftermath of Medical Errors
Academic Psychiatry
Objective Medical errors affect trainees. Existing curricula emphasize tenets of patient safety but rarely address the impact of medical errors on health care providers, particularly at the undergraduate level. The authors developed an interactive session exploring the professional and personal effects of medical errors for 300 second-year medical students. Methods The session utilized case-based learning, small group discussion, and video vignettes. Physicians in multiple specialties were interviewed, sharing narrative accounts of their experience with medical errors and adverse events. Discussions were facilitated by local physicians, who delivered content and shared personal anecdotes. Surveys using a 5-point Likert scale were conducted before and after the session. Results Pre-and post-test surveys resulted in 91 responses in 2016 and 174 in 2017. In 2016, results showed significant change in student responses by 0.34 units (SD 0.35 units; p < 0.001). Two survey items addressing student awareness and three items addressing confidence were significant. The domains assessing students' attitudes and knowledge regarding medical errors were not significant. In 2017, the overall mean change was 0.33 with a lower standard error, 0.03 (p < 0.001), showing significance in both years the session was delivered. Conclusion A 1-h, small-group session increased medical students' understanding of the impact of medical errors and adverse events on providers and the supportive resources available. Recruitment of local faculty to facilitate discussions and share personal anecdotes enhanced the success of the session. Keywords Undergraduate medical education. Burnout. Medical error. Small group learning. Reflection Medical error and adverse patient outcomes affect trainees. Existing curricula focus primarily on improving the error disclosure process by utilizing educational tools such as standardized patient encounters and structured reflection but rarely address the psychological impact of error on healthcare providers, particularly at the undergraduate level [1]. Considering the prevalence of burnout in physicians and the impact of medical error on physician wellness [2], curricula on this topic to prepare future physicians are needed [3, 4]. According to the National Academy of Medicine (NAM), more than half of healthcare providers in the USA exhibit at least one symptom of burnout [5]. Burnout has been associated with increased medical errors and is linked to increased
Teaching and learning population and preventive health: challenges for modern medical curricula
Medical Education, 2005
OBJECTIVES This study aimed to formally identify medical students' attitudes towards population and preventive health issues addressed in the University of Queensland's Bachelor of Medicine, Bachelor of Surgery (MBBS) programme, in response to informal student reports that population and preventive health issues were largely just matters of Ôcommon senseÕ. METHODS Year 2 medical students were surveyed in 1999 and 2000 using a custom-designed instrument incorporating Likert scales and requests for qualitative responses. A sample of students participated in semistructured interviews. RESULTS A total of 341 students (71%) responded to the survey. Students' attitudes towards general population health issues were overwhelmingly positive, and more than 60% of students reported having a more positive attitude towards psychosocial and preventive health issues than they had when they commenced the MBBS programme. Just over half of the students, however, considered population and preventive health issues to be matters of common sense. Students reported poor role modelling by the faculty in relation to population and preventive health issues, with only 41% of students indicating they perceived a positive attitude towards psychosocial and preventive health issues in the School of Medicine. Qualitative data indicated that some students fear that the opportunity cost of dedicating study time to population and preventive health issues might endanger their future clinical knowledge, skills and management of patients. CONCLUSIONS These findings have important implications for modern medical curricula. The challenge in teaching population health issues is to balance students' needs to understand and apply the principles of population and preventive health and the biopsychosocial model of patient care, with the need for them to be confident they will be able to practise safely if they do so. KEYWORDS education, medical, undergraduate ⁄ *methods; attitude; curriculum ⁄ standards; students, medical ⁄ psychology; public health ⁄ education; preventive health services; clinical competence ⁄ standards.
What Do We Know About the Anxieties of Students Starting Clinical Studies
2004
This study aimed to determine anxiety-producing situations among medical students starting clinical studies from their own and their teachers' perspectives. Students' perceived anxieties were assessed by means of a questionnaire. The same questionnaire was given to the teachers involved in clinical training during the fourth year of medical education. Teachers were asked to complete the questionnaire as they thought the introductory students would have done. According to the students, the top five situations that produce anxiety were: giving a wrong treatment, getting diagnoses wrong, carrying out cardiopulmonary resuscitation, inadvertently hurting patients and becoming infected by patients. The situations that were found to be as anxiety producing by the teachers were mostly related to communicating with patients.