Third-Year Medical Students' Reactions to Surgical Patients in Pain: Doubt, Distress, and Depersonalization

Kopecky, Kimberly E.; Zens, Tiffany; Suwanabol, Pasithorn A.; Schwarze, Margaret L.

doi:10.1016/j.jpainsymman.2018.08.008

Cited by 9 publications

(2 citation statements)

References 34 publications

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“…Similarly Dias [66], described medical students experiencing MD when "[participating] in care that [the medical student] does not agree with (abortion appointments)"(p. 6), highlighting the conflict between the Innate Ring with regards to religion and the sanctity of life and the need to meeting clinical obligations which would be part of the societal ring. [67,69,70,73,75,[84][85][86].…”

Section: Inter-ring Conflictsmentioning

confidence: 99%

A systematic scoping review moral distress amongst medical students

et al. 2022

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Background Characterised by feelings of helplessness in the face of clinical, organization and societal demands, medical students are especially prone to moral distress (MD). Despite risks of disillusionment and burnout, efforts to support them have been limited by a dearth of data and understanding of MD in medical students. Yet, new data on how healthcare professionals confront difficult care situations suggest that MD could be better understood through the lens of the Ring Theory of Personhood (RToP). A systematic scoping review (SSR) guided by the RToP is proposed to evaluate the present understanding of MD amongst medical students. Methods The Systematic Evidence-Based Approach (SEBA) is adopted to map prevailing accounts of MD in medical students. To enhance the transparency and reproducibility, the SEBA methodology employs a structured search approach, concurrent and independent thematic analysis and directed content analysis (Split Approach), the Jigsaw Perspective that combines complementary themes and categories, and the Funnelling Process that compares the results of the Jigsaw Perspective with tabulated summaries to ensure the accountability of these findings. The domains created guide the discussion. Results Two thousand six hundred seventy-one abstracts were identified from eight databases, 316 articles were reviewed, and 20 articles were included. The four domains identified include definitions, sources, recognition and, interventions for MD. Conclusions MD in medical students may be explained as conflicts between the values, duties, and principles contained within the different aspects of their identity. These conflicts which are characterised as disharmony (within) and dyssynchrony (between) the rings of RToP underline the need for personalised and longitudinal evaluations and support of medical students throughout their training. This longitudinal oversight and support should be supported by the host organization that must also ensure access to trained faculty, a nurturing and safe environment for medical students to facilitate speak-up culture, anonymous reporting, feedback opportunities and supplementing positive role modelling and mentoring within the training program.

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Section: Inter-ring Conflictsmentioning

confidence: 99%

A systematic scoping review moral distress amongst medical students

et al. 2022

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“…Com relação aos estudantes de enfermagem e medicina, esta realidade não é diferente, uma vez que estes alunos vivenciam uma significativa sobrecarga de atividades (4)(5) , além de Brazilian Journal of Health Review, Curitiba, v. 6, n. 2, p.5453-5470, mar./apr., 2023 outros fatores impactantes, tais como: relacionamentos conflituosos com docentes, exigência severa durante os estágios, cumprimento de prazos, falta de ética profissional (4) , sensação de insegurança técnica e o desgaste relacionado ao contato com pacientes e complicações inesperadas (6) . Tais aspectos culminam em desgaste mental (4) , associados à busca por excelência em práticas e conhecimento, o que pode gerar esgotamento (7) .…”

Section: Introductionunclassified

“Eu comecei a viver a vida universitária em stand by” - fatores que levam à desmotivação acadêmica em estudantes de enfermagem e medicina de uma universidade brasileira

Cassiano¹,

Lucchetti²,

Gonçalves³

et al. 2023

Braz. J. Hea. Rev.

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Objetivo: Identificar e descrever os fatores que levam à desmotivação em estudantes dos cursos de enfermagem e medicina. Metodologia: Estudo qualitativo realizado em uma universidade pública brasileira. Os dados foram coletados no período de julho a setembro de 2018, por meio de entrevistas semiestruturadas e as informações foram gravadas em áudio, transcritas e analisadas segundo a análise de conteúdo. Resultados: Na análise qualitativa, alguns fatores emergiram como associados à desmotivação no ambiente acadêmico, destacando-se as seguintes metacategorias: (1) Contexto de Aprendizado, que incluiu: estrutura curricular (carga horária extensa e uso de metodologias tradicionais de aprendizagem); conduta docente (tratamento hostil do professor com seu aluno, carência didática) e exigências da área da saúde (ambiente de sobrecarga, angústia e sofrimento) e os (2) Aspectos Emocionais, que incluíram: afastamento da família em virtude da necessidade de se estabelecer em outro local (dificuldade de adaptação) e pensamentos negativos, (alterações de saúde mental e risco de suicídio). Conclusão: Diante da diversidade de fatores, as instituições de ensino devem se atentar para a saúde mental dos estudantes de enfermagem e medicina e fornecer suporte que vise o acolhimento das demandas nas esferas biopsicossocioespirituais, visando uma melhoria do processo ensino-aprendizagem.

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The current state of surgical palliative care education: an APDS survey from the Education Committee of the Surgical Palliative Care Society

Wylie,

Kopecky,

Cook

et al. 2024

Global Surg Educ

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Purpose Formal primary surgical palliative care education in the United States is lacking. We aimed to assess curricula and surgical program directors’ (PDs) attitudes toward instituting formal educational programs. Results will be able to guide future efforts to create and standardize educational materials to meet the needs of surgical training programs. Methods An anonymized 15-item survey was developed by the SPCS Education Committee and electronically distributed to PDs at 282 general surgery residency programs through the Association of Program Directors in Surgery (APDS) in June 2023. Results Forty-three PDs completed the questionnaire (15% response rate). Sixty-seven percent reported providing dedicated instruction time for communication skills with seriously ill patients. Most (76%) reported using didactics format, while 48% utilized simulation-based instruction, 35% dedicated time to clinical instruction in the ICU and 14% of programs utilized routine rounding to offer opportunities to teach communication skills. Use of materials created by educators within the institution was most common (69%), followed by SCORE materials (45%) and other established communication tools (7%). 37 (86%) respondents supported the use of standardized education materials if they were to be provided, including resources regarding end-of-life care (65%), decision-making capacity and the care and role of surrogate decision-makers (56%), code status documentation (49%), and ethics of medicalized death (65%). Conclusions Surgical residencies provide variable levels of formal education and utilize different tools and resources to teach primary palliative care and advanced communication skills. While a national standardized formal curriculum does not currently exist, many surgical PDs display positive attitudes toward adopting such materials if made available.

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Third-Year Medical Students' Reactions to Surgical Patients in Pain: Doubt, Distress, and Depersonalization

Cited by 9 publications

References 34 publications

A systematic scoping review moral distress amongst medical students

A systematic scoping review moral distress amongst medical students

“Eu comecei a viver a vida universitária em stand by” - fatores que levam à desmotivação acadêmica em estudantes de enfermagem e medicina de uma universidade brasileira

The current state of surgical palliative care education: an APDS survey from the Education Committee of the Surgical Palliative Care Society

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