Evidence map›Paper›PMID 29945983›Full record

ArticleEmergency medicine journal : EMJ2018

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

Esther Murray, Charlotte Krahé, Danë Goodsman

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Emergency medicine journal : EMJ, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 2 pooled it
14.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

39 citing papers in PubMed, 2 syntheses or guidelines pooled it, 109 citations in OpenAlex.

  1. The Association of Moral Injury and Healthcare Clinicians' Wellbeing: A Systematic Review.International journal of environmental research and public health · 2023
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  12. Exploring paramedic professional identity.British paramedic journal · 2023
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  15. Mental health trends among medical students.Proceedings (Baylor University. Medical Center) · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Esther MurrayCentre for Medical Education, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.ORCID http://orcid.org/0000-0002-3274-6443
Charlotte KrahéDepartment of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Danë GoodsmanCentre for Medical Education, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Queen Mary University of London · GBKing's College London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe 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.

methodsStructured 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.

resultsConcepts 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.

conclusionsThe 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.

Indexed as

MoralsEducation, Medical, GraduateEmergency Medical ServicesEmergency MedicineFocus GroupsHumansInterviews as TopicPilot ProjectsQualitative ResearchStress, PsychologicalStudents, MedicalWorkplacefirst respondersparamedicsprehospital carepsychologystaff support

Identifiers

PMID29945983
PMCPMC6173814
OpenAlexW2811146301

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.