Evidence map›Paper›PMID 34961337›Full record

ArticleInternational journal of psychiatry in medicine2022

Moral Injury during the COVID-19 pandemic: A delphi model survey of family medicine residents.

Sean B Ngo, Payson J Clark, Sarah E Parr, Abel R Thomas, Akshat Dayal, Richard Sanker, Burritt W Hess, Dillon C Stull

Abstract read
In one paragraph

Article in International journal of psychiatry in medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Healing Pandemic Learners: A Call To Action.Journal of general internal medicine · 2025
    Article
  2. Family physicians' moral distress when caring for patients experiencing social inequities: a critical narrative inquiry in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024
    Article
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

8 authors.

Sean B NgoOffice of PreHealth Studies, 174583Baylor University, Waco, TX, USA.ORCID 0000-0001-7298-2662
Payson J ClarkOffice of PreHealth Studies, 174583Baylor University, Waco, TX, USA.
Sarah E ParrOffice of PreHealth Studies, 174583Baylor University, Waco, TX, USA.
Abel R ThomasOffice of PreHealth Studies, 174583Baylor University, Waco, TX, USA.
Akshat DayalOffice of PreHealth Studies, 174583Baylor University, Waco, TX, USA.
Richard SankerOffice of PreHealth Studies, 174583Baylor University, Waco, TX, USA.
Burritt W Hess377644Waco Family Medicine, Waco, TX, USA.
Dillon C Stull10624Stanford University School of Medicine, Stanford, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe objective is to investigate the primary factors that created experiences leading to moral injury in family medicine residents during the COVID-19 pandemic and also to identify any barriers keeping these residents from seeking or receiving help when they experienced moral injury.

methodA DELPHI model study utilizing three rounds of surveys was conducted at four family medicine residency programs in the United States. Resident responses to Survey 1 generated factors perceived to be causing them moral injury or constituting barriers to their seeking help. Thematic analysis identified common themes which were presented to residents in Survey 2 for rating and justification. Results and feedback from Survey 2 were shared with residents in Survey 3, where residents were prompted to reevaluate their ratings for factors and barriers for the purpose of generating consensus among themselves. A ranked list of factors and barriers was thereby created for the participating sites.

resultsResidents shared several stories about the factors that most pressured them to violate their moral values. The most severe and frequent factors contributing to moral injury involved disruptions to doctor-patient relationships, patient-family relationships, and relationships with other healthcare professionals. Time was the major barrier to residents seeking help.

conclusionDuring times of crisis, moral injury among residents may be minimized by protecting and promoting important clinical and professional relationships with patients, colleagues, and other medical professionals. While residents report that lack of time was the most significant barrier to seeking help, it is unclear how this complicated and ubiquitous problem would be resolved or mitigated.

Indexed as

COVID-19Internship and ResidencyStress Disorders, Post-TraumaticFamily PracticeHumansPandemicsSurveys and QuestionnairesUnited StatesCOVID-19family practiceinternship and residencymoral injurypost-traumaticstress disorders

Identifiers

PMID34961337
PMCPMC9209884

What OpenQuestion holds

Textmetadata
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.