Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
BMC Med Educ. 2024 Sep 27;24(1):1055. doi: 10.1186/s12909-024-05972-4.
The COVID-19 pandemic had a significant impact on both the clinical practice and the psychological states of frontline physicians in the emergency department. Trainees, at the beginning of their careers and thus still developing their practice styles and identities as physicians, were uniquely affected.
In this qualitative study, we sought to explore how the pandemic environment shaped the experiences of emergency medicine resident physicians.
This was a qualitative study. We conducted in-depth interviews with emergency medicine faculty, resident physicians, and staff at a single emergency department based at an urban academic institution in the northeastern United States. Interviews were audio recorded and transcribed, and transcripts were then analyzed in an iterative process by our coding team for recurring themes related to the resident experience.
We reached data saturation with 27 individuals. Of those who were interviewed, 10 were resident physicians [6 senior residents (PGY-3 or PGY-4) and 4 junior residents (PGY-1 or PGY-2)]. Three major recurring themes regarding resident physician experience emerged during our analysis of the interviews: (1) novel educational experiences dampened by negative structural forces from the pandemic, (2) fracturing of social interactions and mitigation through ad-hoc support systems and community of practice, and (3) development of negative emotions and psychological trauma including fear, resentment, and moral injury causing lasting harm.
Our results suggest that emergency medicine resident physicians training during the COVID-19 pandemic faced unique experiences concerning their education, social support systems, and emotional states. While the educational and social experiences were described as having both negative and positive impacts, the emotional experiences were largely negative. Residency program leadership may use these insights to improve resident preparation, wellness, and resilience in the face of future adverse events.
COVID-19 大流行对急诊一线医生的临床实践和心理状态都产生了重大影响。住院医师处于职业生涯的初期，因此他们的实践风格和医生身份仍在发展，他们受到的影响尤为独特。
在这项定性研究中，我们试图探讨大流行环境如何塑造急诊住院医师的经历。
这是一项定性研究。我们在位于美国东北部的一所城市学术机构的单一急诊部对急诊医学教师、住院医师和工作人员进行了深入访谈。访谈进行了录音并转录，然后由我们的编码团队对转录本进行迭代分析，以找出与住院医师经历相关的反复出现的主题。
我们对 27 人进行了数据分析，达到了数据饱和。在接受访谈的人中，有 10 人是住院医师[6 名高级住院医师（PGY-3 或 PGY-4）和 4 名初级住院医师（PGY-1 或 PGY-2）]。在对访谈进行分析时，出现了三个关于住院医师经历的主要反复出现的主题：（1）新的教育经历因大流行带来的负面结构性力量而受挫，（2）社交互动破裂，通过临时支持系统和实践社区得以缓解，（3）产生恐惧、怨恨和道德创伤等负面情绪和心理创伤，造成持久伤害。
我们的研究结果表明，在 COVID-19 大流行期间接受培训的急诊住院医师在教育、社会支持系统和情绪状态方面面临独特的经历。虽然教育和社会经历既有积极的影响，也有消极的影响，但情绪经历主要是消极的。住院医师培训项目的领导层可以利用这些见解，在未来面临不利事件时，提高住院医师的准备、健康和适应能力。
