What Do Medical Students Do and Want When Caring for "Difficult Patients"?

Area of Science:

• Medical Education
• Psychology in Medicine
• Clinical Skills Training

Background:

• Medical students experience negative emotions during patient interactions, often for the first time in clinical clerkships.
• Preclinical training addresses difficult patient encounters, but student needs during clinical education are underexplored.
• Understanding student strategies and support desires is crucial for improving clinical learning.

Purpose of the Study:

• To explore medical students' strategies for managing difficult patient interactions.
• To assess students' perceived preparedness from the curriculum for these encounters.
• To identify desired support and training during clinical rotations.

Main Methods:

• Qualitative content analysis of interviews with 26 fourth-year medical students.
• Exploration of strategies used in interactions evoking negative emotions.
• Mapping desired supports to cognitive apprenticeship teaching methods.

Main Results:

• Students employed strategies like finding empathy, using communication skills, anticipating challenges, seeking support, and viewing interactions as growth opportunities.
• Ideal clinical teaching includes validated debriefs and emphasis on emotional reactions.
• Students favored modeling and supported reflection, aligning with cognitive apprenticeship.

Conclusions:

• Medical students utilize some strategies but seek enhanced preparation and support during clinical rotations.
• Student-identified needs align with traditional pedagogy and cognitive apprenticeship techniques.
• Implementing these methods can improve learning for students facing emotionally challenging patient interactions.