Abstract
Background
Reflective practices can help learners process new clinical encounters. We sought to understand how clerkship students process exposure to intense experiences by assigning them to reflect on overnight trauma call.
Methods
Third year medical students participated in one overnight trauma call at our Level 1 trauma center during their required surgery clerkship and submitted written reflections to an online learning management system. Data were deidentified for qualitative analysis by two independent reviewers who identified common themes via qualitative content analysis.
Results
All student reflections from academic year 2021–2022 were analyzed. Primary themes identified were teamwork, novelty, patient humanity, and role-modeling.
Conclusions
Medical student reflections provided insight into the student experience of overnight trauma call. Descriptive data can identify which elements of trauma care are most impactful to students, which may guide educators in how to best support students during these novel clinical experiences.
Similar content being viewed by others
Data availability
The complete deidentified dataset can be requested through the corresponding author.
References
Ryan MS, Feldman M, Bodamer C, Browning J, Brock E, Grossman C. Closing the gap between preclinical and clinical training: impact of a transition-to-clerkship course on medical students’ clerkship performance. Acad Med. 2020;95(2):221–5. https://doi.org/10.1097/ACM.0000000000002934.
Cuban L. Change without reform: the case of Stanford University School of Medicine, 1908–1990. Am Educ Res J. 1997;34(1):83–122. https://doi.org/10.3102/00028312034001083.
Hilton SR, Slotnick HB. Proto-professionalism: how professionalisation occurs across the continuum of medical education. Med Educ. 2005;39(1):58–65. https://doi.org/10.1111/j.1365-2929.2004.02033.x.
Pitkala KH, Mantyranta T. Professional socialization revised: medical students’ own conceptions related to adoption of the future physician’s role–a qualitative study. Med Teach. 2003;25(2):155–60. https://doi.org/10.1080/0142159031000092544.
Kolb DA. Experiential learning: experience as the source of learning and development. Englewood Cliffs, NJ: Prentice Hall; 1984.
Dornan T, Littlewood S, Margolis SA, Scherpbier AJ, Spencer J, Ypinazar V. How can experience in clinical and community settings contribute to early medical education? A BEME systematic review. Med Teach. 2006;28(1):3–18. https://doi.org/10.1080/01421590500410971.
Branch WT. Supporting the moral development of medical students. J Gen Intern Med. 2000. https://doi.org/10.1046/j.1525-1497.2000.06298.x.
Hernandez S, Nnamani Silva ON, Conroy P, Weiser L, Thompson A, Mohamedaly S, Coe TM, Alseidi A, Campbell AR, Sosa JA, Gosnell J, Lin MYC, Roman SA. Bursting the hidden curriculum bubble: a surgical near-peer mentorship pilot program for URM medical students. J Surg Educ. 2022. https://doi.org/10.1016/j.jsurg.2021.07.003.
Curlewis K, Thornhill C, Leung B, Hamilton L, Ricketts D, Rogers B. The effects of sex, race and the hidden curriculum on medical students’ career choices: lessons for orthopaedics. Bull R Coll Surg Engl. 2020. https://doi.org/10.1308/rcsbull.2020.179.
Higashi RT, Tillack A, Steinman MA, Johnston CB, Harper GM. The ‘worthy’ patient: rethinking the ‘hidden curriculum’ in medical education. Anthropol Med. 2013. https://doi.org/10.1080/13648470.2012.747595.
Jackson T, Morgan J, Jackson D, Cook T, McLean K, Agrawal V, Taubman K, Kumar G, Truitt MS. Trends in surgeon wellness (take a sad song and make it better): a comparison of surgical residents, fellows, and attendings. Am Surg. 2019;85(6):579–86. https://doi.org/10.1177/000313481908500620.
Carmassi C, Dell’Oste V, Bertelloni CA, Pedrinelli V, Barberi FA, Malacarne P, Dell’Osso L. Gender and occupational role differences in work-related post-traumatic stress symptoms, burnout and global functioning in emergency healthcare workers. Intensive Crit Care Nurs. 2022;69: 103154. https://doi.org/10.1016/j.iccn.2021.103154.
Delucia JA, Bitter C, Fitzgerald J, Greenberg M, Dalwari P, Buchanan P. Prevalence of post-traumatic stress disorder in emergency physicians in the United States. West J Emerg Med. 2019;20(5):740–6. https://doi.org/10.5811/westjem.2019.7.42671.
Vance MC, Mash HBH, Ursano RJ, Zhao Z, Miller JT, Clarion MJD, West JC, Morganstein JC, Iqbal A, Sen S. Exposure to workplace trauma and posttraumatic stress disorder among intern physicians. JAMA Netw Open. 2021;4(6): e2112837. https://doi.org/10.1001/jamanetworkopen.2021.12837.
Joseph B, Pandit V, Hadeed G, Kulvatunyou N, Zangbar B, Tang A, O-Keeffe T, Wynne J, Green DJ, Friese RS, Rhee P. Unveiling posttraumatic stress disorder in trauma surgeons: a national survey. J Trauma Acute Care Surg. 2014;77(1):148–54. https://doi.org/10.1097/TA.0000000000000271.
d’Ettorre G, Pellicani V, Ceccarelli G. Post-traumatic stress disorder symptoms in healthcare workers: a ten-year systematic review. Acta Biomed. 2020;91(12S): e2020009. https://doi.org/10.23750/abm.v91i12-S.9459.
Al-Mateen CS, Linker JA, Damle N, Hype J, Helfer T, Jessick V. Vicarious traumatization and coping in medical students: a pilot study. Acad Psychiatry. 2015;39:90–3. https://doi.org/10.1007/s40596-014-0199-3.
Neumann M, Edelhäuser F, Tauschel D, Fischer MR, Wirtz M, Woopen C, Haramati A, Scheffer C. Empathy decline and its reasons: a systematic review of studies with medical students and residents. Acad Med. 2011. https://doi.org/10.1097/acm.0b013e318221e615.
Berg GM, Harshbarger JL, Ahlers-Schmidt CR, Lippoldt D. Exposing compassion fatigue and burnout syndrome in a trauma team: a qualitative study. J Trauma Nurs. 2016. https://doi.org/10.1097/jtn.0000000000000172.
Everly GS Jr, Boyle SH, Lating JM. The effectiveness of psychological debriefing with vicarious trauma: a meta-analysis. Stress Med. 1999. https://doi.org/10.1002/(SICI)1099-1700(199910)15:4%3C229::AID-SMI818%3E3.0.CO;2-M.
Morganstein JC, West JC, Ursano RJ. Work-associated trauma. Physician Mental Health Well-Being Res Pract. 2017. https://doi.org/10.1007/978-3-319-55583-6_2.
Head BA, Earnshaw LA, Greenberg RB, Morehead RC, Pfeifer MP, Shaw MA. “I will never forget”: what we learned from medical student reflections on a palliative care experience. J Palliat Med. 2012;15(5):535–41. https://doi.org/10.1089/jpm.2011.0391.
Braun UK, Gill AC, Teal CR, Morrison LJ. The utility of reflective writing after a palliative care experience: can we assess medical students’ professionalism? J Palliat Med. 2013;16(11):1342–9. https://doi.org/10.1089/jpm.2012.0462.
Larson SL, O’Rourke AP. “Rhythm of the Night”: medical student reflections on overnight trauma call. Am J Surg. 2021. https://doi.org/10.1016/j.amjsurg.2021.09.028.
Dressler JA, Ryder BA, Connolly M, Blais MD, Miner TJ, Harrington DT. “Tweet”-format writing is an effective tool for medical student reflection. J Surg Educ. 2018. https://doi.org/10.1016/j.jsurg.2018.03.002.
Graneheim U, Lundman B. Qualitative content analysis in nursing research: concepts, procedures, and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105–12. https://doi.org/10.1016/j.nedt.2003.10.001.
Triangulation DS. The use of triangulation in qualitative research. Oncol Nurs Forum. 2014;41(5):545–7.
Mavis BE, Cole BL, Hoppe RB. A survey of student assessment in US medical schools: the balance of breadth versus fidelity. Teach Learn Med. 2001;13(2):74–9. https://doi.org/10.1207/S15328015TLM1302_1.
Crane MF, Searle BJ, Kangas M, Nwiran Y. How resilience is strengthened by exposure to stressors: the systematic self-reflection model of resilience strengthening. Anxiety, Stress, Coping. 2018;10(1080/10615806):1506640.
Bandini J, Mitchell C, Epstein-Peterson ZD, Amobi A, Cahill J, Peteet J, Balboni T, Balboni MJ. Student and faculty reflections of the hidden curriculum: how does the hidden curriculum shape students’ medical training and professionalization? Am J Hosp Palliat Med. 2017. https://doi.org/10.1177/1049909115616359.
Hafferty FW, Franks R. The hidden curriculum, ethics teaching, and the structure of medical education. Acad Med. 1994;69(11):861–71.
Kentli FD. Comparison of hidden curriculum theories. Eur J Educ Stud. 2009;1(2):83–8.
Dornan T, Boshuizen H, King N, Scherpbier A. Experience-based learning: a model linking the processes and outcomes of medical students’ workplace learning. Med Educ. 2007. https://doi.org/10.1111/j.1365-2929.2006.02652.x.
Dent JA, Harden RM, Hunt D. Curriculum development: the hidden curriculum. In: Hafferty FW, Gaufberg EH, editors. A practical guide for medical teachers. NY: Elsevier; 2017. p. 35–41.
Gaufberg EH, et al. The hidden curriculum: what can we learn from third-year medical student narrative reflections? Acad Med. 2010;85(11):1709–16.
Rankin CH, Abrams T, Barry RJ, Bhatnagar S, Clayton DF, Colombo J, Coppola G, Geyer MA, Glanzman DL, Marsland S, McSweeney FK, Wilson DA, Wu C-F, Thompson RF. Habituation revisited: an updated and revised description of the behavioral characteristics of habituation. Neurobiol Learn Mem. 2009;92(2):135–8. https://doi.org/10.1016/j.nlm.2008.09.012.
Kent J, Thornton M, Fong A, Hall E, Fitzgibbons S, Sava J. Acute provider stress in high stakes medical care: implications for trauma surgeons. J Trauma Acute Care Surg. 2020. https://doi.org/10.1097/ta.0000000000002565.
Charon R. Narrative medicine: a model for empathy, reflection, profession, and trust. J Am Med Assoc. 2001. https://doi.org/10.1001/jama.286.15.1897.
Imperato A, Strano-Paul L. Impact of reflection on empathy and emotional intelligence in third-year medical students. Acad Psychiatry. 2021. https://doi.org/10.1007/s40596-020-01371-1.
Tsingos-Lucas C, Bosnic-Anticevich S, Schneider CR, Smith L. The effect of reflective activities on reflective thinking ability in an undergraduate pharmacy curriculum. Am J Pharm Educ. 2016. https://doi.org/10.5688/ajpe80465.
Acknowledgements
The authors would like to thank the Alpert Medical School students and the Department of Surgery for their support with this project. We would also like to thank our peer reviewers for their insightful comments on our manuscript.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Mair, A., Kurland, K., Lynch, K. et al. Narrative reflections from a night on trauma call: an innovative way to identify with student experiences. Global Surg Educ 3, 15 (2024). https://doi.org/10.1007/s44186-023-00212-7
Received:
Revised:
Accepted:
Published:
DOI: https://doi.org/10.1007/s44186-023-00212-7