Kopstick Avi J, Sanders Benjamin Wilson, Yarris Lalena M, Kelly Serena P
Division of Pediatric Critical Care Medicine, Doernbecher Children's Hospital, Oregon Health and Science University, Portland, Oregon, United States.
Division of General Pediatrics, Doernbecher Children's Hospital, Oregon Health and Science Universality, Portland, Oregon, United States.
J Pediatr Intensive Care. 2021 Jul 1;12(3):210-218. doi: 10.1055/s-0041-1731431. eCollection 2023 Sep.
Learning critical care medicine in the pediatric intensive care unit (PICU) can be stressful. Through semistructured interviews ( = 16), this study explored the emotions, perceptions, and motivations of pediatric medicine (PM) and emergency medicine (EM) residents, as they prepared for their first PICU rotation. Qualitative data were collected and analyzed using the grounded theory method. Three resultant themes emerged: (1) residents entered the PICU with a range of intense emotions and heightened expectations; (2) they experienced prior history of psychologically traumatic learning events (adverse learning experiences or ALEs); and (3) informed by ALEs, residents prepared for their rotation by focusing heavily on their most basic level of physiological needs and adopting a survival mindset prior to the start of the rotation. These three themes led to a substantive, or working, theory that ALE-associated events may affect how residents approach upcoming learning opportunities. Consequently, adapting a trauma-informed approach as a component of medical education may improve resident learning experiences in the PICU and beyond.
在儿科重症监护病房（PICU）学习重症医学可能会有压力。通过半结构化访谈（n = 16），本研究探讨了儿科医学（PM）和急诊医学（EM）住院医师在准备首次PICU轮转时的情绪、认知和动机。使用扎根理论方法收集和分析定性数据。得出了三个主题：（1）住院医师进入PICU时带着一系列强烈的情绪和更高的期望；（2）他们经历过心理创伤性学习事件（不良学习经历或ALEs）的既往史；（3）在ALEs的影响下，住院医师在轮转开始前通过高度关注最基本的生理需求并采取生存心态来为轮转做准备。这三个主题导致了一个实质性的或实用的理论，即与ALEs相关的事件可能会影响住院医师对待即将到来的学习机会的方式。因此，采用创伤知情方法作为医学教育的一个组成部分可能会改善住院医师在PICU及其他环境中的学习体验。
