Third-Year Medical Students' Reactions to Surgical Patients in Pain: Doubt, Distress, and Depersonalization

Journal of Pain and Symptom Management
Kimberly E KopeckyMargaret L Schwarze

Abstract

Medical students have limited instruction about how to manage the interpersonal relationships required to care for patients in pain. The objective of this study was to characterize the experiences of medical students as they encounter pain, suffering, and the emotional experiences of doctoring. We used qualitative analysis to explore the content of 341 essays written by third-year medical students who described their experiences with surgical patients in pain. We used an inductive process to develop a coding taxonomy and then characterized the content of these essays related to empathy, patient-clinician interaction, and descriptions of clinical norms. Students found it difficult to reconcile patient suffering with the therapeutic objective of treatment. They feared an empathic response to pain might compromise the fortitude and efficiency required to be a doctor and they pursued strategies to distance themselves from these feelings. Students described tension around prescription of pain medications and worried about the side effects of medications used to treat pain. Students felt disillusioned when operations caused suffering without therapeutic benefit or were associated with unexpected complications. Although patients had e...Continue Reading

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