Abstract
Learning critical care medicine in the pediatric intensive care unit (PICU) can be
stressful. Through semistructured interviews (n = 16), this study explored the emotions, perceptions, and motivations of pediatric
medicine (PM) and emergency medicine (EM) residents, as they prepared for their first
PICU rotation. Qualitative data were collected and analyzed using the grounded theory
method. Three resultant themes emerged: (1) residents entered the PICU with a range
of intense emotions and heightened expectations; (2) they experienced prior history
of psychologically traumatic learning events (adverse learning experiences or ALEs);
and (3) informed by ALEs, residents prepared for their rotation by focusing heavily
on their most basic level of physiological needs and adopting a survival mindset prior
to the start of the rotation. These three themes led to a substantive, or working,
theory that ALE-associated events may affect how residents approach upcoming learning
opportunities. Consequently, adapting a trauma-informed approach as a component of
medical education may improve resident learning experiences in the PICU and beyond.
Keywords
graduate medical education - pediatrics - emergency medicine - psychological trauma
- burnout - professional
