Fenwick Peri, Furqan Zainab, Cooper Rachel Beth, Tse Emmanuel, Lustig Andrew, Sinyor Mark, Nakhost Arash, Kurdyak Paul, Rudoler David, Naeem Farooq, Stergiopoulos Vicky, Zaheer Juveria
University of Toronto, Toronto, Canada.
Unity Health, Toronto, Canada.
BMC Med Educ. 2025 May 14;25(1):702. doi: 10.1186/s12909-025-07164-0.
Patient suicide is a common adverse event during psychiatric residency. This study aimed to understand psychiatry residents' experiences of patient suicide from the perspectives of psychiatrists who experienced this loss as a resident and/or as a psychiatrist supervising residents, and to assess which interventions may help residents feel supported after such tragedies.
This is a secondary qualitative analysis based on a previous study in which psychiatrists who experienced a patient's death by suicide were interviewed about their experiences. Of the 18 participants interviewed, 13 participants had experienced the death of a patient by suicide during residency and/or had experience supervising residents in the context of this loss. Direct transcriptions from these 13 interviews were analyzed using constructivist grounded theory.
Participants' experiences of patient suicide during training were influenced by the practice setting, patient-related factors, learners' personal circumstances, and the supervisor-trainee relationship. Participants described feeling supported by supervisors from a practical perspective, such as offering a modified workload. Emotional, professional, and existential supports were identified as helpful, though their provision varied depending on the supervisory dynamic. There were differences between resident and supervisor responses to patient suicide, which may be due to residents' fear of negative evaluations and lack of formal training for supervisors.
The experience of a patient's death by suicide during residency is diverse and multifactorial. Encouraging connection within the supervisory relationship is critical for both residents and supervisors in coping with the loss and effectively supporting trainees.
患者自杀是精神科住院医师培训期间常见的不良事件。本研究旨在从曾作为住院医师经历过此类损失和/或作为监督住院医师的精神科医生的角度，了解精神科住院医师对患者自杀的经历，并评估哪些干预措施可能有助于住院医师在这类悲剧发生后获得支持。
这是一项基于先前研究的二次定性分析，在先前研究中，对经历过患者自杀死亡的精神科医生进行了关于其经历的访谈。在接受访谈的18名参与者中，有13名参与者在住院医师培训期间经历过患者自杀死亡和/或在此类损失情况下有监督住院医师的经验。使用建构主义扎根理论对这13次访谈的直接转录内容进行了分析。
培训期间参与者对患者自杀的经历受到实践环境、患者相关因素、学习者个人情况以及监督者与受训者关系的影响。参与者表示从实际角度得到了监督者的支持，例如提供调整后的工作量。情感、专业和存在主义支持被认为是有帮助的，尽管其提供情况因监督动态而异。住院医师和监督者对患者自杀的反应存在差异，这可能是由于住院医师担心负面评价以及监督者缺乏正式培训所致。
住院医师培训期间患者自杀死亡的经历是多样且多因素的。鼓励监督关系中的联系对于住院医师和监督者应对损失并有效支持受训者都至关重要。
