"It's Kind of a Rite of Passage": An Exploration Into Residents' Experience of Learning in a Critical Care Setting.

Journal of graduate medical education Pub Date : 2024-12-01 Epub Date: 2024-12-13 DOI:10.4300/JGME-D-24-00415.1
Avi J Kopstick, Benjamin W Sanders, Kathryn Felmet, Lalena M Yarris, Serena Phromsivarak Kelly
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引用次数: 0

Abstract

Background Many trainees complete rotations in intensive care units (ICUs), but little is known about how ICU rotations impact learners. Understanding residents' experiences in ICU rotations is a crucial step toward improving resident education and understanding the consequences, intended and unintended, of critical care learning. Objective We performed a qualitative study to understand how pediatric and emergency medicine residents experience a pediatric ICU (PICU) rotation. Methods For this phenomenological study, we explored residents' experiences with critical care learning by focusing on the high-stakes, emotionally charged PICU environment. Semistructured interviews were conducted with 12 residents after their first PICU rotation from July 2019 through March 2020. Data were analyzed through line-by-line coding, serial discussions, and consensus meetings. Finally, emergent themes and convergent narratives were constructed around the resident PICU experience. Results Residents perceived the PICU as a challenging environment for independent, self-driven, and active learning. They suffered adverse psychological effects, leading some to "give up" and many to experience feelings consistent with acute traumatic stress. Despite these challenges, residents described their PICU rotation as a "rite of passage" and reported increased comfort with caring for "sick kids." Conclusions Residents describe their PICU rotations as intense experiences that result in increased physician comfort. However, they also endure psychologically traumatic experiences that may hinder them, and the independent practitioners they become, from caring for certain types of patients in the future.

"这是一种仪式":探索住院医生在重症监护环境中的学习体验。
许多学员在重症监护病房(ICU)完成轮转,但很少有人知道ICU轮转如何影响学习者。了解住院医师在ICU轮转中的经验是提高住院医师教育和了解重症监护学习的有意和无意后果的关键一步。目的通过定性研究了解儿科和急诊科住院医师在儿科ICU (PICU)轮转期间的体验。方法在现象学研究中,我们通过关注高风险、情绪化的PICU环境,探讨住院医师在重症监护学习方面的经验。在2019年7月至2020年3月首次PICU轮转后,对12名住院医生进行了半结构化访谈。通过逐行编码、连续讨论和共识会议来分析数据。最后,围绕住院PICU的经历构建了突现主题和趋同叙事。结果住院医师认为PICU是一个具有挑战性的独立、自我驱动和主动学习的环境。他们遭受了不利的心理影响,导致一些人“放弃”,许多人经历了与急性创伤压力一致的感觉。尽管面临这些挑战,居民们将PICU轮转描述为一种“成人仪式”,并报告说照顾“生病的孩子”增加了舒适感。结论:住院医师将PICU轮换描述为一种强烈的体验,可以增加医生的舒适度。然而,他们也承受着心理创伤的经历,这可能会阻碍他们成为独立的从业者,在未来照顾某些类型的病人。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of graduate medical education
Journal of graduate medical education Medicine-Medicine (all)
CiteScore
3.20
自引率
0.00%
发文量
248
期刊介绍: - Be the leading peer-reviewed journal in graduate medical education; - Promote scholarship and enhance the quality of research in the field; - Disseminate evidence-based approaches for teaching, assessment, and improving the learning environment; and - Generate new knowledge that enhances graduates'' ability to provide high-quality, cost-effective care.
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