Preparing for the PICU: A Qualitative Study of Residents as They Prepare for Their First Pediatric Critical Care Rotation

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

Authors' Contributions

A.J.K. conceived and designed the study, collected the data, took responsibility for the data analysis, and was the principal author. B.W.S. made major contributions to the data analysis and interpretation, and he critically revised and made important contributions to the manuscript. L.M.Y. provided major contributions to the study design and data analysis and critically revised and made important contributions to manuscript revisions. S.P.K. was the study's principle investigator and critically revised and made important contributions to manuscript revisions. All authors approved the final manuscript for submission.

Publication History

Received: 23 March 2021

Accepted: 17 May 2021

Article published online:
01 July 2021

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