Original Article

Second Victim Experience among OBGYN Trainees: What Is Their Desired Form of Support?

Authors: Vanessa E. Torbenson, MD, Kirsten A. Riggan, MA, MS, Amy L. Weaver, MS, Margaret E. Long, MD, Robyn E. Finney, DNAP, Megan A. Allyse, PhD, Enid Rivera-Chiauzzi, MD

Abstract

Objectives: Physician trainees in obstetrics and gynecology (OBGYN) experience unexpected outcomes similar to those of supervising physicians. A relative lack of experience and perspective may make them more vulnerable to second victim experience (SVE), however.

The objectives of our study were to contrast the prevalence of SVE between supervising physicians and trainees and to identify their preferred methods of support.

Methods: In 2019, the Second Victim Experience and Support Tool, a validated survey with supplemental questions, was administered to healthcare workers caring for OBGYN patients at a large academic center in the midwestern United States.

Results: The survey was sent to 571 healthcare workers working in OBGYN. A total of 205 healthcare workers completed the survey, including 18 (43.9% of 41) supervising physicians and 12 (48.0% of 25) resident/fellow physicians. The mean scores for the Second Victim Experience and Support Tool dimensions and outcomes were similar between the two groups. Seven (58.3%) trainees reported feeling like a second victim after an adverse patient safety event at some point in their work experience compared with 10 (55.6%) of the supervising physicians. Five (41.7%) trainees identified as a second victim in the previous 12 months compared with 3 (16.7%) supervising physicians (P = 0.21). The most common form of desired support for both groups was conversations with their peers.

Conclusions: Trainees and supervising physicians are both at risk of SVE after an unexpected medical event and prefer conversations with peers as a desired form of support. Because trainees commonly encounter SVEs early in their careers, program directors should consider implementing a program for peer support after an unexpected event.
Posted in: Obstetrics and Gynecology70

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References

1. Wu AW. Medical error: the second victim. The doctor who makes the mistake needs help too. BMJ 2000;320:726–727.   2. Scott SD, Hirschinger LE, Cox KR, et al. The natural history of recovery for the healthcare provider “second victim” after adverse patient events. Qual Saf Health Care 2009;18:325–330.   3. Heiss K, Clifton M. The unmeasured quality metric: burn out and the second victim syndrome in healthcare. Semin Pediatr Surg 2019;28:189–194.   4. Burlison JD, Scott SD, Browne EK, et al. The Second Victim Experience and Support Tool: validation of an organizational resource for assessing second victim effects and the quality of support resources. J Patient Saf 2017;13:93–102.   5. Margulies SL, Benham J, Liebermann J, et al. Adverse events in obstetrics: impacts on providers and staff of maternity care. Cureus 2020;12:e6732.   6. Engel KG, Rosenthal M, Sutcliffe KM. Residents’ responses to medical error: coping, learning, and change. Acad Med 2006;81:86–93.   7. Stehman CR, Testo Z, Gershaw RS, et al. Burnout, drop out, suicide: physician loss in emergency medicine. Part I. West J Emerg Med 2019;20:485–494.   8. Gupta K, Lisker S, Rivadeneira NA, et al. Decisions and repercussions of second victim experiences for mothers in medicine (SAVE DR MoM). BMJ Qual Saf 2019;28:564–573.   9. Maslach C, Jackson SE, Leiter MP. Maslach Burnout Inventory Manual. 3rd ed. Palo Alto, CA: Consulting Psychologists Press; 1996.   10. West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. J Intern Med 2018;283:516–529.   11. West CP, Tan AD, Habermann TM, et al. Association of resident fatigue and distress with perceived medical errors. JAMA 2009;302:1294–1300.   12. Shanafelt TD, Balch CM, Bechamps G, et al. Burnout and medical errors among American surgeons. Ann Surg 2010;251:995–1000.   13. Dyrbye LN, Thomas MR, Massie FS, et al. Burnout and suicidal ideation among U.S. medical students. Ann Intern Med 2008;149:334–341.   14. Smith RP. Burnout in obstetricians and gynecologists. Clin Obstet Gynecol 2019;62:405–412.   15. Sinsky CA, Dyrbye LN, West CP, et al. Professional satisfaction and the career plans of US physicians. Mayo Clin Proc 2017;92:1625–1635.   16. West CP, Dyrbye LN, Erwin PJ, et al. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. Lancet 2016;388:2272–2281.   17. Tan H. Debriefing after critical incidents for anaesthetic trainees. Anaesth Intensive Care 2005;33:768–772.   18. Schmidt M, Haglund K. Debrief in emergency departments to improve compassion fatigue and promote resiliency. J Trauma Nurs 2017;24:317–322.   19. Rivera-Chiauzzi EY, Smith HA, Moore-Murray T, et al. Healing our own: a randomized trial to assess benefits of peer support. J Patient Saf 2020; doi: 10.1097/PTS.0000000000000771.