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Abstract
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.
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.
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.
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.