Abstract Manager

Oral

OC1-1-3

Accept

I declare I have no actual or potential conflict of interest in relation to this program.

no

General Call (Workshop, Oral Presentation, Poster Presentation)

Oral

Education Research

Student

yes

Exploring how providing care for stigmatized patients influences the moral development of medical learners

In acute hospital settings, medical trainees provide care for many stigmatized patient populations such as patients who inject drugs (PWID) and are often confronted with ethical dilemmas inherent to their care. Although providing care to these populations likely contributes to trainee's moral development, little research has explored its impact. As part of a larger study exploring the inpatient care of PWID patients, we identified how social and material forces may be playing a role in shaping trainee moral development.

We conducted a qualitative study informed by sociomaterial theories. Data consisted of observational field notes from 48 medical learners, 8 interviews and medical documentations from inpatient units of two urban hospitals in Ontario, Canada. Constant comparative coding and analysis were conducted consistent with constructivist grounded theory methodology.

In contrast to other patient populations, caring for PWID patients appeared to frequently trigger a sense of frustration in learners. In certain learners, this frustration is observed to further perpetuated a sense of indifference and avoidance behaviour. Numerous social and material entities appeared to play a role in shaping this outcome, including: the cyclic nature of treatment, perceptions of stigma, difficulty establishing patient rapport, variability in supervisory practices of senior residents and attending physicians, and material influences such as hospital policy and physical environment.

Existing practices may hinder the moral development of medical trainees involved in the care of stigmatized populations such as PWID. Recognizing and addressing the moral experiences within clinical training provides an opportunity to improve equity and address health disparities.

Stigmatized population

Medical Learner

Acute Inpatient Setting

Undergraduate

Teaching and learning

Undergraduate

Postgraduate

Yes

Yes

Yes

Yes

Yes