The psychological effects of a four-week emergency medicine rotation on residents in training.

Abstract

To prospectively evaluate psychological stress reactions among residents in an emergency medicine (EM) rotation during a 4-week period. Pre- and postrotation psychological distress levels were assessed over a 4-week EM rotation. Subjects were evaluated by several psychometric measures. These included the assessment of anxiety, depressive, and other psychological symptoms by the Brief Symptom Inventory (BSI), and the occurrence of traumatic anxiety via the Dissociative Experience Scale (DES). Also assessed were the Impact of Events Scale and the Holmes Social Readjustment Ratings Scale (Holmes), a baseline life-change measure. Demographic data were obtained. The study occurred in a university-affiliated teaching hospital ED. The 45 EM residents and 27 non-EM residents were analyzed as a group, followed by subgroup analysis comparing EM vs non-EM residents. An increase in psychological distress over the 4-week rotation was found in the non-EM group, but not in the EM group. For the non-EM residents, all 10 BSI scales worsened and 3 of 4 DES scales worsened (p = 0.002), indicative of increased psychological distress. In contrast, analysis of the 45 EM residents showed improvement in 8 of 10 BSI scales and 3 of 4 DES scales (p = 0.057). A significant increase in psychologic distress was found among the non-EM residents during an EM rotation. The EM residents showed a trend for a decrease in psychological distress over the same 4-week period.