title: Psychological impact on house staff of an initial versus subsequent emergency medicine rotation.
abstract: The objective of this study was to assess the psychological impact of a 4-week emergency medicine (EM) rotation on residents undergoing their first EM experience. These findings were compared to the psychological impact the rotation had on residents with prior EM experience. Data were obtained from a post hoc analysis of a previous study. Prerotation and postrotation psychological distress levels were assessed over a 4-week EM rotation. Anxiety and depressive symptoms were evaluated by the Brief Symptom Inventory and the Dissociative Experience Scale that together comprise a total of 14 psychometric scales. All scales were given at the beginning and end of the initial EM rotation for the academic year of 1994-1995. All information was coded and confidential. Eighteen junior residents (9/18 EM [50%]) were analyzed as a group and compared to 53 residents (34/51 EM [66%]) with prior exposure to the authors' emergency department. Residents doing their first EM rotation (N = 18) showed improvement in 13 of 14 scales (P = .002). Of the 13 scales that improved, 3 improved significantly: Brief Symptom Inventory = anxiety (P = .002) and Dissociative Experience Scale = absorption (P = .001) and other (P = .001). Residents with prior EM experience (N = 53) displayed worsening in 9 of 13 scales (P = not significant) and no change in 1. Residents undergoing their first EM rotation showed a significant decrease in psychological distress over the 4-week period. Residents with prior EM experience did not show a similar change.
authors.affiliation: Department of Emergency Medicine, Long Island Jewish Medical Center, Long Island Campus, Albert Einstein College of Medicine, New Hyde Park, NY, USA. alagappa@lij.edu
authors.forename: K
authors.initials: K
authors.lastname: Alagappan
authors.forename: N
authors.initials: N
authors.lastname: Grlic
authors.forename: M
authors.initials: M
authors.lastname: Steinberg
authors.forename: S
authors.initials: S
authors.lastname: Pollack
mesh_terms: D000328:Adult; D002055:Burnout, Professional / Q000453:epidemiology / Q000517:prevention & control; D004635:Emergency Medicine / Q000193:education*; D004636:Emergency Service, Hospital; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D008297:Male; D009519:New York City; D011569:Psychiatric Status Rating Scales; D011787:Quality of Health Care; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology*; D014940:Work Schedule Tolerance