BackgroundDoctors, especially doctors-in-training such as residents, make errors. They have to face the consequences even though today’s approach to errors emphasizes systemic factors. Doctors’ individual characteristics play a role in how medical errors are experienced and dealt with. The role of gender has previously been examined in a few quantitative studies that have yielded conflicting results. In the present study, we sought to qualitatively explore the experience of female residents with respect to medical errors. In particular, we explored the coping mechanisms displayed after an error. This study took place in the internal medicine department of a Swiss university hospital.MethodsWithin a phenomenological framework, semi-structured interviews were conducted with eight female residents in general internal medicine. All interviews were audiotaped, fully transcribed, and thereafter analyzed.ResultsSeven main themes emerged from the interviews: (1) A perception that there is an insufficient culture of safety and error; (2) The perceived main causes of errors, which included fatigue, work overload, inadequate level of competences in relation to assigned tasks, and dysfunctional communication; (3) Negative feelings in response to errors, which included different forms of psychological distress; (4) Variable attitudes of the hierarchy toward residents involved in an error; (5) Talking about the error, as the core coping mechanism; (6) Defensive and constructive attitudes toward one’s own errors; and (7) Gender-specific experiences in relation to errors. Such experiences consisted in (a) perceptions that male residents were more confident and therefore less affected by errors than their female counterparts and (b) perceptions that sexist attitudes among male supervisors can occur and worsen an already painful experience.ConclusionsThis study offers an in-depth account of how female residents specifically experience and cope with medical errors. Our interviews with female residents convey the sense that gender possibly influences the experience with errors, including the kind of coping mechanisms displayed. However, we acknowledge that the lack of a direct comparison between female and male participants represents a limitation while aiming to explore the role of gender.

Answering patients' evolving, more complex needs has been recognized as a main incentive for the development of interprofessional care. Thus, it is not surprising that patient-centered practice (PCP) has been adopted as a major outcome for interprofessional education. Nevertheless, little research has focused on how PCP is perceived across the professions. This study aimed to address this issue by adopting a phenomenological approach and interviewing three groups of professionals: social workers (n = 10), nurses (n = 10) and physicians (n = 8). All the participants worked in the same department (the General Internal Medicine department of a university affiliated hospital). Although the participants agreed on a core meaning of PCP as identifying, understanding and answering patients' needs, they used many dimensions to define PCP. Overall, the participants expressed value for PCP as a philosophy of care, but there was the sense of a hierarchy of patient-centeredness across the professions, in which both social work and nursing regarded themselves as more patient-centered than others. On their side, physicians seemed inclined to accept their lower position in this hierarchy. Gieryn's concept of boundary work is employed to help illuminate the nature of PCP within an interprofessional context.

AIMS: Involvement of medical students in the coronavirus disease 2019 (COVID-19) response remains a matter of debate. The main argument against involvement relates to potential physical and psychological health risks. Hence, we aimed to compare the physical and psychological health of Swiss medical students involved in the COVID-19 response with their non-involved peers. Among those involved, we also compared frontline (working in a dedicated COVID-19 unit) and non-frontline students. In addition, we compared frontline medical students with frontline residents. METHODS: We conducted a cross-sectional anonymous online study in Switzerland between 9 and 14 May 2020. Recruitment was through hospital, faculty and student societies mailing lists using a snowball technique. Exposure to COVID-19 patients, personal protective equipment (PPE) access, support and information by employer, as well as COVID-19 symptoms and diagnosis were collected with a self-reported questionnaire. Anxiety and depression were assessed using the Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9). Burnout was assessed using two single items derived from the Maslach Burnout Inventory. RESULTS: 550 medical students (66.7% women, median age 23 years) and 227 residents (70.5% women, median age 30 years) were included in the analyses. Approximately half of the medical students were involved in the COVID-19 response and 30% were frontline workers. Of the residents, 61.7% were frontline workers. Both medical students and residents reported high access to PPE, support and information by employer. Students involved in the COVID-19 response reported a similar proportion of COVID-19 symptoms or confirmed diagnoses (p = 0.81), but lower levels of anxiety (p <0.001), depression (p <0.001) and burnout (p <0.001 for depersonalisation item), compared with their non-involved peers. Health outcomes of frontline students did not differ significantly compared with their non-frontline peers. Frontline students had lower levels of burnout than frontline residents (p <0.01 for emotional exhaustion item); the remaining health outcomes did not significantly differ.CONCLUSIONS: In a snowball sample of Swiss medical students involved in the response to the first wave of the COVID-19 pandemic, we observed similar physical and psychological health outcomes compared with their noninvolved peers. The context in which medical students are involved is certainly critical. Access to PPE, perceived support by employers and perceived passage of information by employers could explain these findings. Further research is needed to better understand the role of these contextual factors on student physical and psychological health.

Background Virus outbreaks such as the current SARS-CoV-2 pandemic are challenging for health care workers (HCWs), affecting their workload and their mental health. Since both, workload and HCW's well-being are related to the quality of care, continuous monitoring of working hours and indicators of mental health in HCWs is of relevance during the current pandemic. The existing investigations, however, have been limited to a single study period. We examined changes in working hours and mental health in Swiss HCWs at the height of the pandemic (T1) and again after its flattening (T2). Methods We conducted two cross-sectional online studies among Swiss HCWs assessing working hours, depression, anxiety, and burnout. From each study, 812 demographics-matched participants were included into the analysis. Working hours and mental health were compared between the two samples. Results Compared to prior to the pandemic, the share of participants working less hours was the same in both samples, whereas the share of those working more hours was lower in the T2 sample. The level of depression did not differ between the samples. In the T2 sample, participants reported more anxiety, however, this difference was below the minimal clinically important difference. Levels of burnout were slightly higher in the T2 sample. Conclusions Two weeks after the health care system started to transition back to normal operations, HCWs' working hours still differed from their regular hours in non-pandemic times. Overall anxiety and depression among HCWs did not change substantially over the course of the current SARS-CoV-2 pandemic.