Retraumatization in Undergraduate Medical Education: Evaluating the Prevalence and Support Resources Available to Students

Abstract

BACKGROUND: Retraumatization is the conscious or unconscious reminder of past trauma that results in a re-experiencing of the initial traumatic event. This phenomenon has been well-studied in primary and secondary education and has been shown to negatively impact the learning environment. Retraumatization in the context of undergraduate medical education has yet to be evaluated. Therefore, we sought to explore the prevalence of retraumatization in medical students, identify specific areas of UME that are retraumatizing, and evaluate effectiveness of psychological support available to students. METHODS: A survey was created by a multidisciplinary team of health professions educators, revised through an iterative process, and distributed to all medical students at a single, large, academic institution. Respondents who endorsed prior trauma exposure met inclusion criteria for completing the survey. Data was analyzed using Microsoft Excel. RESULTS: Of the school’s 1400 students, 85 responses were recorded for a response rate of 6.07%; this consisted of 20 males (23.5%), 46 females (54.1%), and 19 nonbinary (22.4%) students. 32 (37.6%) students reported no prior trauma and were excluded from survey completion. Of the 53 (62.4%) students completing the survey, retraumatization was experienced by 32 students (60.4%), which represents a prevalence of 37.6% among all medical students surveyed. 50% of females (n=23), 10% of males (n=2), and 36.8% of nonbinary (n=7) students reported retraumatization. Clinical rotations were identified as a retraumatizing setting by 59.3% (n=19) of students. Despite the availability of support services, 11 students (20.8%) reported being unaware of them when experiencing retraumatization. When asked about utilization of services, the majority of those who had experienced retraumatization did not utilize them (65.6%, n=21). CONCLUSION: Retraumatization is occurring in undergraduate medical education, particularly in the clinical years. Medical schools should attempt to enhance the ease of utilization of support resources to improve the learning environment for students.