Joshi Ishani, Zemel Rachel
Department of Internal Medicine, University of Washington, Seattle, WA, USA.
Department of Internal Medicine and Pediatrics, MedStar Georgetown University Hospital, Washington, DC, USA.
Am J Hosp Palliat Care. 2025 Feb;42(2):133-139. doi: 10.1177/10499091241253283. Epub 2024 May 20.
Medical students are educated through two dichotomous curriculums, the formal, planned curriculum and the hidden curriculum unintentionally taught through socialization within the culture of medicine. As a consequence of shared trauma amongst the physician workforce during the COVID-19 pandemic, moral injury (MoI) and compassion fatigue (CoF) have become prevalent within the health care system, including palliative care medicine, with echoing ramifications on the observing trainee population. Thus, it is imperative to determine risk factors, protective factors and targeted interventions to offset MoI and CoF within the health care workforce and trainee population. Methods of strengthening personal and institutional resilience are vital to developing long-term structural change replacing the hidden curriculum of MoI and CoF with one of resilience and support. As palliative care providers are especially vulnerable to MoI and CoF, this article will examine the impact of the COVID-19 pandemic on MoI, CoF, and resilience within the hidden curriculum through the lens of palliative care.
医学生通过两种截然不同的课程接受教育，一种是正式的、有计划的课程，另一种是在医学文化中通过社会化无意传授的隐性课程。由于在新冠疫情期间医生群体中存在共同的创伤，道德伤害（MoI）和同情疲劳（CoF）在包括姑息治疗医学在内的医疗保健系统中变得普遍，对观察到的实习医生群体产生了相应的影响。因此，确定风险因素、保护因素和针对性干预措施以抵消医疗保健人员和实习医生群体中的道德伤害和同情疲劳至关重要。加强个人和机构复原力的方法对于实现长期结构性变革至关重要，用一种具有复原力和支持性的课程取代道德伤害和同情疲劳的隐性课程。由于姑息治疗提供者特别容易受到道德伤害和同情疲劳的影响，本文将通过姑息治疗的视角审视新冠疫情对隐性课程中的道德伤害、同情疲劳和复原力的影响。
