Beverly Elizabeth A, Díaz Sebastián, Kerr Anna M, Balbo Jane T, Prokopakis Kayla E, Fredricks Todd R
a Department of Family Medicine , Ohio University Heritage College of Osteopathic Medicine , Athens , Ohio , USA.
b Department of Medicine , Ohio University Heritage College of Osteopathic Medicine , Athens , Ohio , USA.
Teach Learn Med. 2018 Jan-Mar;30(1):5-14. doi: 10.1080/10401334.2017.1330690. Epub 2017 Jul 28.
Phenomenon: Trigger warnings are verbal statements or written warnings that alert students in advance to potentially distressing material. Medical education includes numerous subjects frequently identified as triggers, such as abuse, rape, self-injurious behaviors, eating disorders, drug and alcohol addiction, and suicide. Thus, exploring medical students' perceptions of trigger warnings may provide a valuable perspective on the use of these warnings in higher education.
As part of a larger descriptive, cross-sectional survey study on medical education, we assessed 1st- and 2nd-year medical students' perceptions of trigger warnings in the preclinical curriculum. Five questions specific to trigger warnings explored students' knowledge, prior experience, and perceptions of trigger warnings in medical education. Frequencies of individual question responses were calculated, and qualitative data were analyzed via content and thematic analyses.
Of the 424 medical students invited to participate, 259 completed the survey (M = 24.8 years, SD + 3.4, 51.4% female, 76.1% White, 53.7% 1st-year students). Few students (11.2%) were aware of the term trigger warning and its definition. However, after being presented with a formal definition on the online survey, 38.6% reported having had a professor use one. When asked whether they supported the use of trigger warnings in medical education, respondents were distributed fairly equally by response (yes = 31.0%, maybe = 39.2%, no = 29.7%). Qualitative analysis revealed three themes: (a) Trigger Warnings Allow Students to Know What is Coming and Prepare Themselves: Respondents believed that trigger warnings would benefit students with a history of trauma by providing them additional time to prepare for the material and, if appropriate, seek professional help; (b) Students Need to Learn How to Handle Distressing Information: Respondents agreed that they needed to learn and cope with highly sensitive material because they would be confronted with difficult and unexpected situations in clinical practice; and (c) Trigger Warnings Help Students Understand the Severity of the Material: Respondents felt that trigger warnings may help students understand the severity of the material being covered and increase awareness about trauma and its effects on health and well-being. Insights: Findings did not reach consensus for or against the use of trigger warnings in medical school; however, students emphasized the importance of learning how to cope with distressing material. Trigger warnings may represent a teaching tool to facilitate classroom discussions about the severity of trauma-related material and problem-focused coping strategies.
现象：触发警告是一种口头声明或书面警告，会提前提醒学生注意可能令人痛苦的内容。医学教育包含众多常被视为触发因素的主题，如虐待、强奸、自残行为、饮食失调、药物和酒精成瘾以及自杀。因此，探究医学生对触发警告的看法可能会为高等教育中这些警告的使用提供有价值的观点。
作为一项关于医学教育的更大规模描述性横断面调查研究的一部分，我们评估了一年级和二年级医学生对临床前课程中触发警告的看法。五个关于触发警告的特定问题探究了学生对医学教育中触发警告的了解、既往经历和看法。计算了各个问题回答的频率，并通过内容分析和主题分析对定性数据进行了分析。
在受邀参与的424名医学生中，259人完成了调查（平均年龄M = 24.8岁，标准差SD = 3.4，51.4%为女性，76.1%为白人，53.7%为一年级学生）。很少有学生（11.2%）知道“触发警告”这个术语及其定义。然而，在在线调查中看到正式定义后，38.6%的学生表示曾有教授使用过触发警告。当被问及是否支持在医学教育中使用触发警告时，受访者的回答分布较为均衡（是 = 31.0%，也许 = 39.2%，否 = 29.7%）。定性分析揭示了三个主题：（a）触发警告让学生知晓即将出现的内容并做好准备：受访者认为触发警告会使有创伤史的学生受益，因为这能为他们提供额外时间来为相关内容做准备，并在适当情况下寻求专业帮助；（b）学生需要学习如何处理令人痛苦的信息：受访者一致认为他们需要学习并应对高度敏感的内容，因为他们在临床实践中会面临困难和意想不到的情况；（c）触发警告帮助学生理解内容的严重性：受访者认为触发警告可能有助于学生理解所涵盖内容的严重性，并提高对创伤及其对健康和幸福影响的认识。见解：研究结果对于医学院使用触发警告并未达成支持或反对的共识；然而，学生强调了学习如何应对令人痛苦内容的重要性。触发警告可能是一种教学工具，有助于促进课堂上关于创伤相关内容严重性及以问题为导向的应对策略的讨论。
