ArticlePerspectives on medical education2021
Structural distress: experiences of moral distress related to structural stigma during the COVID-19 pandemic.
Article in Perspectives on medical education, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Resident Physicians' Work-Related Emotional Experiences: A Scoping Review of Qualitative Research.Journal of general internal medicine · 2026Pooled it
- The emerging trends of healthcare professions' ethics education in recent 10 years: a systematic review.Frontiers in medicine · 2026Pooled it
- Pooled it
- How 'Cracks' in Canada's Public Services System Manifested as Moral (Di)Stress or Resilience for Emergency Management Personnel During COVID-19: A Critical Realist Study.International journal of environmental research and public health · 2026Article
- Facing hard truths: Medical education's reckoning with settler colonialism in an era of reconciliation.Medical education · 2026Article
- Experiences of Moral Distress in Canadian Intensive Care Unit Professionals During and After the COVID-19 Pandemic: A Qualitative Exploratory Multiple Case Study in Ontario and Alberta, Canada.Journal of intensive care medicine · 2025Article
- "There's just such a mismatch": a qualitative exploration of health systems and organizational-level barriers to accessing cancer services among people experiencing structural marginalization.International journal for equity in health · 2025Article
- Residents Navigating Moral Distress After theO&G open · 2025Article
- Trainee resistors: Have our students become our teachers?Medical education · 2025Article
- 'We tried our best... it wasn't great': a qualitative study of clinician experiences on child psychiatry wards at the height of COVID-19.BMC health services research · 2024Article
- Moral Stress and Moral Distress: Confronting Challenges in Healthcare Systems under Pressure.The American journal of bioethics : AJOB · 2024Article
- PROTOCOL: Effects of social prescribing for older adults: An evidence and gap map.Campbell systematic reviews · 2024Article
- "I Went Into This Field to Empower Other People, and I Feel Like I Failed": Residents Experience Moral Distress Post-Journal of graduate medical education · 2024Article
- Equity M&M - Adaptation of the Morbidity and Mortality Conference to Analyze and Confront Structural Inequity in Internal Medicine.Journal of general internal medicine · 2024Article
- Correlation between moral distress and clinical competence in COVID-19 ICU nurses.BMC nursing · 2023Article
- Wellbeing Convene during COVID-19: A pilot intervention for improving wellbeing and social connectedness for staff, students, residents, and faculty.Journal of clinical and translational science · 2023Article
- It is Challenging to Shift the Norm: Exploring how to Anticipate and Address Microaggressions in Clinical Learning Environments.Perspectives on medical education · 2023Article
- Evaluating the impact of COVID-19 pandemic on the physicians' psychological health: A systematic scoping review.Frontiers in medicine · 2023Article
- Decision Conflicts in Clinical Care during COVID-19: A Multi-Perspective Inquiry.Healthcare (Basel, Switzerland) · 2022Article
- Adapting despite "walls coming down": Healthcare providers' experiences of COVID-19 as an implosive adaptation.Perspectives on medical education · 2022Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe COVID-19 pandemic has taken a significant toll on the health of structurally vulnerable patient populations as well as healthcare workers. The concepts of structural stigma and moral distress are important and interrelated, yet rarely explored or researched in medical education. Structural stigma refers to how discrimination towards certain groups is enacted through policy and practice. Moral distress describes the tension and conflict that health workers experience when they are unable to fulfil their duties due to circumstances outside of their control. In this study, the authors explored how resident physicians perceive moral distress in relation to structural stigma. An improved understanding of such experiences may provide insights into how to prepare future physicians to improve health equity.
methodsUtilizing constructivist grounded theory methodology, 22 participants from across Canada including 17 resident physicians from diverse specialties and 5 faculty members were recruited for semi-structured interviews from April-June 2020. Data were analyzed using constant comparative analysis.
resultsResults describe a distinctive form of moral distress called structural distress, which centers upon the experience of powerlessness leading resident physicians to go above and beyond the call of duty, potentially worsening their psychological well-being. Faculty play a buffering role in mitigating the impact of structural distress by role modeling vulnerability and involving residents in policy decisions.
conclusionThese findings provide unique insights into teaching and learning about the care of structurally vulnerable populations and faculty's role related to resident advocacy and decision-making. The concept of structural distress may provide the foundation for future research into the intersection between resident well-being and training related to health equity.
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