Ethical conflicts and moral distress experienced by paediatric residents during their training
Notice bibliographique
Résumé
BACKGROUND: Paediatric residents experience numerous ethical conflicts; some of these are experienced by all paediatricians, while others are specifically related to residency training. It has been reported that medical students often feel that they are placed in positions that compromise their own ethical principles. A study in the United States showed that interns frequently face examples of unethical and/or unprofessional conduct among staff. OBJECTIVES: To identify the ethical conflicts and moral distress experienced by paediatric residents during their training. METHODOLOGY: Data were collected from four focus groups, which were organized according to the four separate years of residency training. Focus groups consisting of four to 10 participants were led by a research assistant. The focus groups were recorded by an audio device and transcribed verbatim; all data that would identify any of the participants or staff were eliminated. Data analysis involved a modified thematic analysis. The study was approved by the Research Ethics Board at the Hospital for Sick Children in Toronto, Ontario. RESULTS: While residents occasionally face traditional paediatric ethical issues, such as 'do not resuscitate' orders, more often they experience conflicts because of their inexperience and their place in the hierarchy of the medical care team, particularly when there is disagreement between trainees and senior staff. Their ability to deal and cope with these issues changes as they go through their training. Many residents in the first part of their training were more frustrated and confused with ethical conflicts. In these cases, residents found their best support from their peers and other senior residents. Residents in the later years of training seemed more accustomed to ethical issues. Furthermore, almost all of the residents believed that other members of their health care team have acted in an unethical or unprofessional way. CONCLUSION: Paediatric residents experience significant ethical conflicts and moral distress. Understanding these ethical issues will help those responsible for postgraduate medical education to review or revise the ethics curriculum in keeping with the current moral distress experienced by residents, and help to mentor and guide trainees.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,007 | 0,036 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,003 | 0,004 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,001 | 0,004 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».