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Are medical students in prehospital care at risk of moral injury?

Murray, E, Krahé, C and Goodsman, D (2018) Are medical students in prehospital care at risk of moral injury? Emergency Medicine Journal, 35 (10). pp. 590-594. ISSN 1472-0205

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Background The term 'moral injury' may be useful in conceptualising the negative psychological effects of delivering emergency and prehospital medicine as it provides a non-pathological framework for understanding these effects. This is in contrast to concepts such as burnout and post-Traumatic stress disorder which suggest practitioners have reached a crisis point. We conducted an exploratory, pilot study to determine whether the concept of moral injury resonated with medical students working in emergency medicine and what might mitigate that injury for them. Methods Structured interviews and focus groups were carried out with medical students involved in the delivery of prehospital and emergency medicine. The study was carried out at Barts and the London School of Medicine and Dentistry in May and June 2017. The data were analysed using theoretically driven thematic analysis. Results Concepts of moral injury such as witnessing events which contravene one's moral code, especially those involving children, or acts of violence, resonated with the experiences of medical students in this study. Participants stated that having more medical knowledge and a clear sense of a job to do on scene helped reduce their distress at the time. While social support was a protective factor, not all students found the process of debrief easy to access or undergo, those with more established relationships with colleagues fared better in this regard. Conclusions The term moral injury is useful in exploring the experience of medical students in emergency medicine. More effort should be made to ensure that students effectively access debrief and other support opportunities. It is hoped that future work will be undertaken with different professional groups and explore the potential psychological and neuropsychological impact of witnessing trauma.

Item Type: Article
Uncontrolled Keywords: Humans; Focus Groups; Pilot Projects; Stress, Psychological; Morals; Emergency Medicine; Qualitative Research; Education, Medical, Graduate; Students, Medical; Workplace; Emergency Medical Services; Interviews as Topic; first responders; paramedics; prehospital care; psychology; staff support; Education, Medical, Graduate; Emergency Medical Services; Emergency Medicine; Focus Groups; Humans; Interviews as Topic; Morals; Pilot Projects; Qualitative Research; Stress, Psychological; Students, Medical; Workplace; Emergency & Critical Care Medicine; 1103 Clinical Sciences; 1110 Nursing; 1117 Public Health and Health Services
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Divisions: Psychology (from Sep 2019)
Publisher: BMJ
SWORD Depositor: A Symplectic
Date Deposited: 05 Sep 2022 10:35
Last Modified: 05 Sep 2022 10:35
DOI or ID number: 10.1136/emermed-2017-207216
URI: https://researchonline.ljmu.ac.uk/id/eprint/17488
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