Short Sydney L, Akhtar Saadia, Johnson Mallory, Sims Lillian R, Goldstein Larry B, Jones Kimberly S
College of Medicine, University of Kentucky.
Department of Behavioral Science, University of Kentucky; and.
Neurol Educ. 2025 Sep 8;4(3):e200244. doi: 10.1212/NE9.0000000000200244. eCollection 2025 Sep.
Exposure to emotionally taxing patients can lead to secondary trauma that can result in burnout and emotional exhaustion in healthcare providers. Understanding whether secondary trauma is present in medical students could provide an opportunity to address the issue earlier in physician training. We sought to determine if secondary trauma characteristics exist in third-year medical students during a combined neurology/emergency medicine clerkship.
Six cohorts of third-year medical students at a MD-granting institution were invited to complete the Professional Quality of Life Survey, a widely used tool for assessing secondary trauma and its associated symptoms of compassion fatigue and burnout in healthcare workers. This was combined with supplemental questions and a standard postrotation survey to explore medical students' emotional experiences during the clerkship. The strength of the associations was measured with Cramér's V.
The survey had a 51% response rate (n = 100) with 11.3% reporting symptoms of secondary trauma. Of the respondents, 81% identified as White, 6% as Black/African American, 6% as Asian, and 2% as American Arab/Middle Eastern/North African; 60% identified as female and 37% as male. Contributors to secondary trauma could be grouped into 4 themes: 1, feeling helpless in the student role; 2, witnessing the physical consequences of patient diseases; 3, personal trauma history; and 4, empathy burden. Most students expected the level of emotional distress they experienced during the clerkship. Hobbies, wellness activities, talking to others, and avoidance were common reported coping strategies. Participation in hobbies was associated with less emotional exhaustion (Cramér's V = 0.372; = 0.001). Feelings of increased preparedness were associated with less emotional exhaustion (Cramér's V = 0.395; = 0.005).
Secondary trauma characteristics were identified in 11.3% of third-year medical students during a combined neurology/emergency medicine clerkship. This provides an opportunity to incorporate interventions that are effective in reducing secondary trauma characteristics in physicians during this early stage of training. Recognizing and proactively reducing secondary trauma during the clerkship experience may have longer-term benefits during later stages of medical training and practice.
接触情绪负担重的患者可能导致继发性创伤，进而使医护人员产生职业倦怠和情绪耗竭。了解医学生中是否存在继发性创伤，可为在医师培训早期解决该问题提供契机。我们试图确定在神经病学/急诊医学联合实习期间，三年级医学生是否存在继发性创伤特征。
邀请一所授予医学博士学位机构的六组三年级医学生完成《职业生活质量调查》，这是一种广泛用于评估医护人员继发性创伤及其相关的同情疲劳和职业倦怠症状的工具。该调查还结合了补充问题和标准的实习后调查问卷，以探究医学生在实习期间的情绪体验。关联强度用克莱姆V系数衡量。
调查回复率为51%（n = 100），11.3%的学生报告有继发性创伤症状。在受访者中，81%为白人，6%为黑人/非裔美国人，6%为亚洲人，2%为阿拉伯裔/中东/北非裔美国人；60%为女性，37%为男性。继发性创伤的促成因素可分为4个主题：1. 在学生角色中感到无助；2. 目睹患者疾病的身体后果；3. 个人创伤史；4. 共情负担。大多数学生预期了他们在实习期间经历的情绪困扰程度。爱好、健康活动、与他人交谈和回避是常见的应对策略。参与爱好与较少的情绪耗竭相关（克莱姆V系数 = 0.372；P = 0.001）。准备更充分的感觉与较少的情绪耗竭相关（克莱姆V系数 = 0.395；P = 0.005）。
在神经病学/急诊医学联合实习期间，11.3%的三年级医学生被发现有继发性创伤特征。这为在培训早期阶段纳入有效减少医师继发性创伤特征的干预措施提供了契机。在实习经历中认识并积极减少继发性创伤，可能在医学培训和实践的后期阶段带来长期益处。
