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Am J Surg. 2009 Jan;197(1):107-12. doi: 10.1016/j.amjsurg.2008.07.048.

Moral distress in the third year of medical school; a descriptive review of student case reflections.

Author information

1
Department of Surgery, Vanderbilt University Medical Center, Room D5203 MCN, Nashville, TN 37232-2577, USA. kim.lomis@vanderbilt.edu

Abstract

BACKGROUND:

Medical students may find certain clinical experiences particularly difficult. Moral distress occurs when a trainee sees a situation or behavior as undesirable, but, because of a position in the hierarchy, declines to address the problem. To prompt our students to reflect on such experiences, students are required to submit a brief case description and are assigned to mentor groups to discuss cases.

METHODS:

After exemption from our Institutional Review Board, a database of student submissions was de-identified. A total of 192 case descriptions were analyzed by a single reviewer to identify recurrent themes. Submissions were categorized in a binary fashion as higher or lower levels of distress. Frequency and correlation with levels of distress were assessed for each theme.

RESULTS:

Sixty-seven percent of the submissions were classified as higher distress. Seven major themes were identified, the most common being problems of communication (n = 179). Those students taking action correlated to lower distress.

CONCLUSIONS:

Our review shows that specific situations can be expected to generate moral distress in trainees. Addressing such distress may support the ongoing professional growth of trainees.

PMID:
19101252
DOI:
10.1016/j.amjsurg.2008.07.048
[Indexed for MEDLINE]

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