Curated Collection for Educators: Five Key Papers About Second Victim Syndrome

Abstract

Second victim syndrome (SVS) is defined as the psychological or emotional suffering of healthcare workers as a result of a patient adverse, or near miss, event. Initially thought to be related to medical error, we now recognize that SVS can result from a much wider range of circumstances including adverse pediatric patient events, unanticipated deaths, or patients well known to the provider. Residents are particularly susceptible to SVS yet relatively little is written about this topic targeted at their educators. Since educators are positioned to help recognize and guide learners through the experience, this paper targets that reader audience. In this article, we identify and summarize five key papers relevant to educators interested in learning more about SVS as it relates to learners. We identified an extensive list of papers relevant to SVS via online discussions within the Academic Life in Emergency Medicine (ALiEM) Faculty Incubator. The Faculty Incubator is a digital community of practice providing professional development for educators. This list was augmented by an open call on Twitter seen by over 2000 people and yielding a list of 31 papers. We then conducted a three-round modified Delphi process within the authorship group, which included both junior and senior clinician educators, to identify the most impactful papers for educators interested in SVS. The three-round modified Delphi process ranked all papers submitted for review and used iterative rounds to select the five highest-rated papers for inclusion in this article. The group then summarized each of the five papers with specific consideration for junior faculty educators and faculty developers with an interest in SVS in learners. The five papers featured in this article serve as a key reading list for educators across specialties interested in SVS and our commentary provides context for medical educators using the articles.

Extinguishing burnout: National analysis of predictors and effects of burnout in abdominal transplant surgery fellows

“…3 Furthermore, while the result of solid organ transplant for patients is transformative and life-saving, the complexities of patient management and high incidence of patient mortality in the transplant and end-stage organ disease populations make transplant surgeons vulnerable to feelings of shame, guilt, and helplessness. [12][13][14][15] In this study, we set out to assess the prevalence of burnout among abdominal transplant surgery fellows. We sought to identify predictors of burnout and to understand its impact on personal and patient care during fellowship.…”

“…This fellowship is particularly demanding requiring long, irregular work hours with more on‐call responsibilities than most other fellowships 3 . Furthermore, while the result of solid organ transplant for patients is transformative and life‐saving, the complexities of patient management and high incidence of patient mortality in the transplant and end‐stage organ disease populations make transplant surgeons vulnerable to feelings of shame, guilt, and helplessness 12‐15 …”

It’s the Culture!—How systemic and societal constructs impact well‐being

“…41,42 Following major adverse events, the healthcare provider may experience multiple physical and psychosocial symptoms, including grief, shame, intrusive thoughts, musculoskeletal disorders, and cardiovascular symptoms. 43,44 Some contemplate career change, and some suffer the additional stress of malpractice litigation, which complicates the path to recovery. 32,45 Although peer support can help in such moments, there are barriers to access, including fears of litigation and lack of legally protected confidentiality.…”

“…This was defined as the second victim syndrome (SVS) in 2000 by Wu 40 and can significantly contribute to burnout 41,42 . Following major adverse events, the healthcare provider may experience multiple physical and psychosocial symptoms, including grief, shame, intrusive thoughts, musculoskeletal disorders, and cardiovascular symptoms 43,44 . Some contemplate career change, and some suffer the additional stress of malpractice litigation, which complicates the path to recovery 32,45 .…”

The Prevalence of Second Victim Syndrome and Emotional Distress in Pediatric Intensive Care Providers

“…9,20 Initially, the need for peer support was thought of as being limited to cases of medical error, litigation, or challenging family disclosures. 6 Programs have evolved to provide peer support in a variety of scenarios including following an unanticipated patient event, a difficult patient outcome, or a morally distressing situation. 20,21 You Matter and Take Care Peer Support Programs Our institutional peer support programs include "You Matter" for physicians and advanced practice providers (APPs) and "Take Care" for nurses, respiratory therapists, and ancillary staff.…”