Responding to vicarious trauma experienced by junior doctors during hospital-based rotations: A narrative review considering effective approaches that have been used in healthcare settings

Abstract

Transitioning from being a medical student to a junior doctor is stressful. Junior doctors must find ways to cope with unfamiliar clinical work in rapidly changing environments. Hospital-based placements can also expose junior doctors to vicarious trauma which cumulatively and disproportionately impacts the less experienced.

Objectives

Psychological debriefing continues to be implemented and advocated as a reactive approach to limit the effects of vicarious trauma. However, the literature strongly suggests this approach does not reduce the risk of developing post-traumatic stress disorder and may worsen symptoms. To identify alternatives to supporting junior doctors, a narrative literature search was conducted across multiple databases to identify relevant information. Alternatives to psychological debriefing included resilience training, mindfulness-based intervention, Schwartz rounds and somatic experiencing. While these novel interventions are promising, caution must be exercised, the evidence base is limited.

Conclusions

Exposure to distressing events may be unavoidable for junior doctors. As hospitals look for better ways to address vicarious trauma, caution must be exercised to follow the evidence rather than implement a solution-focused ideology that may be harmful. Our findings suggest the need to focus on proactive rather than reactive approaches. Further research is needed.