460 - Post-Traumatic Growth in Pediatric Residents at a Single Academic Center

Friday, April 28, 2023

5:15 PM – 7:15 PM ET

Poster Number: 460
Publication Number: 460.122

Faye Mendoza, Lucile Packard Children's Hospital Stanford, Mountain View, CA, United States; Sarah L. Hilgenberg, Lucile Packard Children's Hosp, Stanford, CA, United States; Sarrah Hussain, Stanford University School of Medicine, Stanford, CA, United States

Presenting Author(s)

Faye Mendoza, MD (she/her/hers)

Pediatric Resident / Rising Chief Resident
Lucile Packard Children's Hospital Stanford
Mountain View, California, United States

Background: Pediatric residency is a rigorous training period that can be exacerbated by distressing clinical events such as poor patient outcomes, conflict with team members, and extreme fatigue. While most literature has studied the negative effects of trauma, new focus has emerged on the positive psychological change associated with trauma: post-traumatic growth. In the mid-1990s, psychologists Richard Tedeschi and Lawrence Calhoun developed a framework for post-traumatic growth, with positive changes in five distinct domains: closer relationships, personal strength, greater appreciation for life, new possibilities, and spiritual development. While the COVID-19 pandemic has jumpstarted novel research on post-traumatic growth in frontline providers, this phenomenon has not yet been explored in pediatric residents after distressing clinical events.

Objective: To describe experiences of post-traumatic growth in pediatric residents

Design/Methods: In this IRB-approved, exploratory qualitative study, pediatric resident author (FM) conducted interviews with volunteer PGY-1 to PGY-3 pediatric residents at Stanford in December 2022. Interviews were audio recorded, transcribed verbatim and de-identified. Using thematic analysis, two authors independently coded transcripts and a third author helped to develop consensus. Recruitment continued until we reached thematic sufficiency.

Results:

In distressing clinical events, residents experienced lack of control or support from team members; exclusion from conversations; inadequate debriefs; witnessing injustice; and high emotional investment. Despite these events, pediatric residents did experience positive changes in established domains of post-traumatic growth (Table 1). Beyond established domains, we also discovered themes specific to post-traumatic growth by pediatric residents: 1) the need for strong social connection with others who understand their unique medical experiences and 2) the desire to increase advocacy for both themselves as residents and in their care for patients (Table 2).

Conclusion(s): While the experiences of pediatric residents fell within the established domains and had unique aspects, we also found that that trauma did not stem entirely from the distressing clinical event but had contributing factors such as feeling unsupported by a resident’s own team or inadequate debriefing. Findings from this study will enhance awareness for individuals responsible for programs that promote resident well-being, in order to facilitate post-traumatic growth in pediatric residents after distressing clinical events.