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Narrative reflections from a night on trauma call: an innovative way to identify with student experiences

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Global Surgical Education - Journal of the Association for Surgical Education Aims and scope Submit manuscript

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.

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Data availability

The complete deidentified dataset can be requested through the corresponding author.

References

  1. 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.

    Article  PubMed  Google Scholar 

  2. 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.

    Article  Google Scholar 

  3. 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.

    Article  PubMed  Google Scholar 

  4. 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.

    Article  PubMed  CAS  Google Scholar 

  5. Kolb DA. Experiential learning: experience as the source of learning and development. Englewood Cliffs, NJ: Prentice Hall; 1984.

    Google Scholar 

  6. 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.

    Article  PubMed  CAS  Google Scholar 

  7. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  8. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  9. 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.

    Article  Google Scholar 

  10. 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.

    Article  PubMed  Google Scholar 

  11. 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.

    Article  PubMed  Google Scholar 

  12. 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.

    Article  PubMed  Google Scholar 

  13. 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.

    Article  PubMed Central  Google Scholar 

  14. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  15. 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.

    Article  PubMed  Google Scholar 

  16. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  17. 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.

    Article  PubMed  Google Scholar 

  18. 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.

    Article  Google Scholar 

  19. 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.

    Article  PubMed  Google Scholar 

  20. 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.

    Article  Google Scholar 

  21. 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.

    Article  Google Scholar 

  22. 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.

    Article  PubMed  Google Scholar 

  23. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  24. 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.

    Article  PubMed  Google Scholar 

  25. 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.

    Article  PubMed  Google Scholar 

  26. 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.

    Article  PubMed  CAS  Google Scholar 

  27. Triangulation DS. The use of triangulation in qualitative research. Oncol Nurs Forum. 2014;41(5):545–7.

    Article  Google Scholar 

  28. 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.

    Article  PubMed  CAS  Google Scholar 

  29. 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.

    Google Scholar 

  30. 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.

    Article  Google Scholar 

  31. Hafferty FW, Franks R. The hidden curriculum, ethics teaching, and the structure of medical education. Acad Med. 1994;69(11):861–71.

    Article  PubMed  CAS  Google Scholar 

  32. Kentli FD. Comparison of hidden curriculum theories. Eur J Educ Stud. 2009;1(2):83–8.

    Google Scholar 

  33. 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.

    Article  PubMed  Google Scholar 

  34. 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.

    Google Scholar 

  35. 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.

    Article  PubMed  Google Scholar 

  36. 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.

    Article  PubMed  Google Scholar 

  37. 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.

    Article  PubMed  Google Scholar 

  38. 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.

    Article  Google Scholar 

  39. 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.

    Article  PubMed  Google Scholar 

  40. 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.

    Article  PubMed  PubMed Central  Google Scholar 

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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.

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Correspondence to Anneliese Mair.

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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

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