Aims Paediatrics can be a challenging career. Trainees are expected to develop strategies for coping with emotionally difficult situations both personally and as a team in their training.1 Anecdotally, the emotional impact of working in paediatrics can take a toll on trainees in terms of increased sickness or indeed a career change. There was anecdotal evidence that the support available to trainees was variable across the training programme. We were aware of some perceived stigmata around discussions about these issues.
We aimed to explore trainees’ experiences of emotionally difficult situations, the support they accessed and whether the provision of psychological input would be helpful.
Methods We conducted an online survey of the experiences of paediatric trainees in our deanery in 2014.
Results 104 of 250 trainees responded to the survey (response rate 42%); 97 (93%) reported they had experienced a difficult and/or traumatic clinical scenario during their training. This was most commonly the death of a child 33(32%) or a complex resuscitation of a neonate 31(30%) but a range of other scenarios were described. Most trainees accessed support from their peers (66%) with slightly fewer from consultants (64%). Worryingly, 8% reported no support was made available to them. One-to-one and/or team debriefs were a valued by many trainees (55%). The limitations of shift patterns often meant that these meetings were delayed for some time which reduced the effectiveness. 45 (43%) respondents felt access to confidential psychological support might be helpful with 29 indicating they would value the input of a psychologist.
Conclusion This survey confirms that most trainees experience emotionally difficult situations during their paediatric training. The support available to them is varied. This study highlights that better use of a timely debrief meetings, availability of psychology input and increased consultant leadership could improve the resilience of trainees in coping with the challenges of paediatrics.
Curriculum for Paediatric Training. General Paediatrics. Level 1, 2 and 3 Training. September 2010, revised July 2013. RCPCH. http://www.rcpch.ac.uk/sites/default/files/page/2010%20General%20Paediatrics%20%20curriculum%20July%202014.pdf