This study examined the effects of a stress inoculation training program on self-reported Type A behaviour pattern (TABP) and irrational beliefs in a sample of female medical, dental, and graduate students. Thirteen female medical students from the first, second, and third years of medical school, one female dental student from the first year of dental school, and 16 female graduate student volunteers were assigned to a 6-week stress inoculation group (SI; n = 14) or a 4-hour brief treatment group (BT; n = 16) in a repeated measures (pre, post, 11-week follow-up) quasi-experimental design. Participants completed the Rational Behavior Inventory, the Irrational Beliefs Test, the Type A Irrational Beliefs Test, and the Framingham Type A Scale (modified) in order to assess treatment effects. Price's (1982) cognitive social learning model proposes that TABP is elicited and maintained, in part, by specific beliefs and the fears and anxieties that they engender. Following this model, it was hypothesized that self-reported TABP, irrational beliefs, and Type A irrational beliefs would significantly decrease, and rational behaviour, or general rational thinking, would significantly increase, from pre- to post-test and these changes would be maintained at 11-week follow-up in the SI group, compared with the BT group. Repeated measures MANOVAs with pre-planned contrasts indicated that SI was effective in significantly reducing TABP from pre-to post-test. Both SI and BT were effective in significantly decreasing irrational beliefs and Type A irrational beliefs, as well as significantly increasing rational behaviour, or general rational thinking, from pre to post-test. These changes were maintained at follow-up and provide further insight into the relationship between TABP and irrational beliefs. This study provides partial support for Price's model and implicates the use of stress inoculation training in the treatment of TABP in female medical, dental, and graduate students. Implications of these findings and suggestions for future research are discussed. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

Most research on medical professional socialization was conducted when medical students were almost uniformly white, upper- to upper-middle class, young men. Today 50% of medical students in Canada are women, and significant numbers are members of racialized minority groups, come from working class backgrounds, identify as gay or lesbian, and/ or are older. This research examined the impact of such social diversity on processes of corriing to identify as a medical professional, drawing on a survey of medical students in one third-year class, interviews with 25 third-year students, and interviews with 23 medical school faculty members. Almost all of the traits and processes noted by classic studies of medical professional socialization were found to still apply in the late 1990s. Students learn to negotiate complex hierarchies; develop greater self-confidence, but lowered idealism; learn a new language, but lose some of their communication skills with patients. They begin playing a role that becomes more real as responses from others confirm their new identity. Students going through this training process achieve varying degrees of integration between their medical-student selves and the other parts of themselves. There is a strong impetus toward homogeneity in medical education. It emphasizes the production of neutral, undifferentiated physicians - physicians whose gender, 'race/ sexual orientation, and social class background do not make any difference. While there is some recognition that patients bring social baggage with them into doctor-patient encounters, there is very little recognition that doctors do too, and that this may affect the encounter. Instances of blatant racism, sexism, and homophobia are not common. Nonetheless, students describe an overall climate in the medical school in which some women, students from racialized minority groups, gays and lesbians, and students from working class backgrounds seem to 'fif less well. The subtlety of these micro-level experiences of gendering, racialization and so on allows them to co-exist with a prevalent individual and institutional denial that social differences make any difference. I critique this denial as (unintentionally) oppressive, rooted in a liberal individualist notion of equality that demands assimilation or suppression of difference.

Most research on medical professional socialization was conducted when medical students were almost uniformly white, upper- to upper-middle class, young men. Today 50% of medical students in Canada are women, and significant numbers are members of racialized minority groups, come from working class backgrounds, identify as gay or lesbian, and/ or are older. This research examined the impact of such social diversity on processes of corriing to identify as a medical professional, drawing on a survey of medical students in one third-year class, interviews with 25 third-year students, and interviews with 23 medical school faculty members. Almost all of the traits and processes noted by classic studies of medical professional socialization were found to still apply in the late 1990s. Students learn to negotiate complex hierarchies; develop greater self-confidence, but lowered idealism; learn a new language, but lose some of their communication skills with patients. They begin playing a role that becomes more real as responses from others confirm their new identity. Students going through this training process achieve varying degrees of integration between their medical-student selves and the other parts of themselves. There is a strong impetus toward homogeneity in medical education. It emphasizes the production of neutral, undifferentiated physicians - physicians whose gender, 'race/ sexual orientation, and social class background do not make any difference. While there is some recognition that patients bring social baggage with them into doctor-patient encounters, there is very little recognition that doctors do too, and that this may affect the encounter. Instances of blatant racism, sexism, and homophobia are not common. Nonetheless, students describe an overall climate in the medical school in which some women, students from racialized minority groups, gays and lesbians, and students from working class backgrounds seem to 'fif less well. The subtlety of these micro-level experiences of gendering, racialization and so on allows them to co-exist with a prevalent individual and institutional denial that social differences make any difference. I critique this denial as (unintentionally) oppressive, rooted in a liberal individualist notion of equality that demands assimilation or suppression of difference. / Arts, Faculty of / Sociology, Department of / Graduate

A review was made of research concerning medical students, nursing students, physicians and nurses with special focus on the physician-nurse relationship. Research was carried out to investigate medical and nursing students' concepts of self, ideal self (as physician/nurse), typical work partner and ideal work partner.

As third-year medical students transition from the classroom to the high-stakes, high-stress environment of the emergency department (ED), they confront a unique set of challenges that result in significant personal trauma. The literature offers limited insight into the trauma experienced specifically during the shift to emergency medicine (EM) as medical students’ first clinical rotation. The purpose of this study was to bridge this gap by examining the interplay between students’ perceived psychological safety of their ED teams and their own self-efficacy on the trauma they experienced as learners when working in this unique learning environment. This mixed-methods study included interviews with 17 third-year medical students who immediately completed the EM clerkship at an urban, academic ED. The study addressed four main questions: 1) What types of trauma do students experience in the EM clerkship as they transition from the classroom into the clinical learning environment for the first time in their training? What are the factors of the learning environment that trigger trauma? 2) In what ways, if any, do students’ intersectional demographics affect their experiences of trauma during the EM clerkship? 3) To what extent does general self-efficacy predict medical students’ perceptions of the psychological safety afforded by their clinical team during the EM clerkship? 4) How are students’ experiences of trauma associated, if at all, with perceived psychological safety? What factors in the clinical learning environment contribute to psychological safety or its lack? This study utilized several data collection methods: (a) a pre-interview questionnaire soliciting information on student demographics and responses to items on the General Self-Efficacy Scale, (b) in-depth interviews using the critical incident technique, and (c) responses to items from the Team Psychological Safety Questionnaire. Several key findings emerged. A substantial amount of trauma that students experienced was rooted in a lack of peer support and student empowerment. Various triggers for trauma were identified that transcended different types of trauma. Demographic factors, such as race/ethnicity and gender, influenced the prevalence and nature of these traumatic experiences, with students from underrepresented backgrounds reporting deeper emotional connections with patients. While student self-efficacy was generally high, it did not correlate with the perceived psychological safety provided by their clinical teams. Furthermore, the perception of psychological safety within ED teams correlated with the nature of trauma experienced; those with lower safety scores reported trauma connected to peer support or issues related to cultural, historical, and gender considerations. Lastly, the opportunity for students to safely take risks or learn from mistakes, coupled with their own medical knowledge limitations, emerged as central to their perception of psychological safety within the team dynamic. Deeper insights into the data were revealed through a cross-interview analysis, and several analytical categories were used to further synthesize and interpret the data. Six conclusions were drawn from the study’s findings and analysis: 1) Medical students experience different types of primary trauma when immersed in the ED. 2) Several forces that are intrinsic to the ED workplace influence the trauma students experience. 3) Clerkship leadership must be aware of the unique experiences underrepresented students have in the EM clerkship. 4) The psychological safety provided to students by their teams impacts their experiences of trauma in the ED. 5) Self-efficacy offers a lens to understand students’ experiences of trauma in the ED, but it is insufficient. 6) Clerkship-specific interventions exist to amplify the team psychological safety afforded to medical students.