Are you ready for it? A call for a second victim phenomenon training
Abstract
Introduction: The 'second victim phenomenon' refers to feelings of guilt or failure following an unanticipated outcome or error. This phenomenon is extremely prevalent in the medical field. Over 50% of healthcare professionals experience a second victim phenomenon at least once in their career. Despite the extensive coverage of organ systems and diseases, there remains a significant gap in preparing medical students for the inevitable trauma they will face as physicians. Traumatic events can include life-altering accidents, difficult conversations during end-of-life care, and instances of abuse. Our study aims to elucidate the need for a program that teaches medical students healthy coping mechanisms.
Methods: A secure, anonymous survey was created using REDCap to be sent to medical students of all four years at Eastern Virginia Medical School (EVMS). This IRB-approved survey included basic descriptor questions and also asked students how prepared they felt to cope with traumatic events, whether their school currently has a curriculum in place to teach them healthy coping mechanisms, and whether they believe a formal curriculum should be implemented. This survey was open to students between July 12th-July 26th of 2024, and it could only be answered by a student once. Our survey received 68 responses (11.3% response rate).
Results: Most of the students who answered this survey were in their 1st year (39.7%) and third year (42.6%) during the 2023-2024 academic year. 32.4% of these students took one gap year before attending medical school, and 27.9% took over three gap years. 66.2% of students reported that their institution did not adequately prepare them for traumatic events. 95.6% of students said that they would be open to their medical school providing educational resources for healthy coping mechanisms, and 58.8% believe this should be a required program within the curriculum. 51.5% of students believe this course should be held during the pre-clerkship phase. Medical students in their third and fourth years, specifically, were asked to disclose if they experienced a traumatic event during their clinical rotations. 73.7% reported that they have, and only 60.7% of students felt prepared for it. In addition, peer debriefing sessions, incorporation into clinical skills workshops, resiliency training, end-of-life care training, discussions on what to say during difficult conversations, sessions with trained psychologists, and reminders of available resources during rotations were included in the survey's additional comments section.
Conclusion: This study brings awareness to the mental health challenges associated with a career in medicine. Coping mechanisms for traumatic incidents should be part of the formal instruction to promote the well-being of physicians. Thus, we are working with experts in the fields of education and mental health to design and implement a program within medical school curricula that will provide students with mental health resources.