Residents' Learning Experiences about Patients' Social Difficulties in the Emergency Department: Qualitative Research

Emergency departments (EDs) are increasingly tasked with addressing the complex needs of patients whose daily lives are threatened by non-biomedical factors. To optimize learning about social determinants of health in EDs, it is important to better understand residents' experiences and learning processes in this context.

This qualitative study aimed to explore how residents with positive attitudes toward treating patients with social difficulties in the ED approach such cases and what they learn from these interactions. We selected a hospital where many ED patients present with complex social needs. The hospital is committed to non-discriminatory and equitable medical care and welfare, with educational policies that integrate patients' social backgrounds into daily care. Physicians in postgraduate years 1-7 were recruited purposively. In-depth online interviews were conducted, and data were analyzed using thematic analysis (a framework approach).

A total of 13 physicians participated, with three main themes emerging: (i) healing care in the ED, (ii) positive learning experiences, and (iii) conflict and resolution. Participants described providing healing care in the ED, noting the challenges they faced and the learning opportunities they gained. They emphasized the importance of understanding and responding to patients' needs while noting conflicts in the workplace.

Novice physicians who have a positive attitude toward social problems in EDs approached patients with a non-judgmental attitude, provided healing-oriented care, and aimed to foster their professional development. They often experienced conflict that experts in health professions education need to address to better support residents.