Date of Award

January 2018

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Karen Jubanyik

Abstract

DEPERSONALIZATION IN THE EMERGENCY DEPARTMENT. Damian Apollo, Karen Jubanyik. Department of Emergency Medicine, Yale University, School of Medicine, New Haven, CT.

Yale medical students have given feedback about the emergency medicine rotations via the end of clerkship feedback and the annual student mistreatment questionnaires collected by the medical school and stated that they felt distress and that patient depersonalization occurred during resuscitations. Accordingly, the objectives of this study were to assess medical students’ perspectives with regards to resuscitation exposure, depersonalization, utilization of support services, and support services that students thought would be helpful as well as the timeframe in which these interventions should occur. We hypothesized that many students are exposed to resuscitations, awareness of support services is high while utilization is low, and that students value a post-resuscitation intervention proximate to the event. Our study revealed that 54.76% (n = 215) of medical students are exposed to a code during their training with 43.43% exposed to 5 or more codes during their training. The majority of code exposures occurred in emergency medicine (50.60%), internal medicine (27.11%), and surgery (7.83%). Of those students involved in codes, 57.55% were directly involved in the resuscitation. Of the students involved in emergency resuscitations, 74.00% felt depersonalization occurred with 59.18% seeing it as necessary/natural and 40.82% seeing it as problematic/something that warrants intervention. It was determined that 92.39% of respondents have not used support services. Awareness of resources available was low, with only 20.18% of respondents aware that meeting with the Dean of Student affairs (the category with the greatest awareness) was a possible support service and some students not being aware of any resources. Many students (43.09%) felt that the department of emergency medicine did not offer adequate support services, with 56.82% of respondents believing that additional resources are needed for students exposed to emergency resuscitations. Students preferred an intervention proximate to the event with 29.25% favoring an intervention immediately after the event, 30.61% within 1 day, and 29.25% within 1 week. A preference was placed on an intervention that involved a trained debriefer, a peer/clinical individual, and an individual who does not grade the student. These results suggest that depersonalization during resuscitations is experienced by medical students and that a significant amount of students believe that an intervention could be helpful if implemented as part of the emergency medicine curriculum.

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This is an Open Access Thesis.

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