‘Practice not ignoring hard things’

Navigating moral distress, burnout symptoms, and resilience among medical students working in underserved clinical settings

Bibliographic Data

ID21448653
AuthorsEmily K M Scott (0000-0001-9295-9320, University of Colorado System), Chad Stickrath (0000-0002-9246-4990, University of Colorado System), Marta A W Rowh (0000-0001-9584-7826, University of Colorado System, corresponding author)
Year2026
Volume48
Issue2
Pages280-288
Publication date2026-02-01
Open AccessNo
TypeARTICLE
VenueMedical Teacher (JOURNAL)
Journal identifiersISSN: 0142-159X • E-ISSN: 1466-187X
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/0142159x.2025.2536695
PMID40697041
OpenAlexW4412616947
LanguageEN
References cited22

INTRODUCTION: Medical students can experience moral distress related to patient encounters during clinical training which can impact student wellbeing. We aimed to characterize themes associated with demonstrated resilience versus burnout symptoms in response to moral distress related to challenging patient encounters working with marginalized communities. METHODS: We conducted a qualitative analysis of written reflections on challenging clinical encounters by 3rd-year medical students placed in underserved clinical settings. Iterative thematic analysis with inductive and deductive coding was performed by two researchers. RESULTS: Fifty reflections from 21 students during the 2022-2024 academic years were included in the analysis. Key themes emerging from reflections included approaching distressing patient encounters with curiosity and realistic optimism - defined as the ability to recognize and mitigate structural barriers without internalizing them as personal failures - was associated with empathy and resilient behavior. Reflections highlighted debriefing, 'rewind' skills, and written reflections as potential tools for promoting resilient framing of challenging clinical experiences. DISCUSSION: Our findings highlight potential tools to promote resilience in medical students in response to challenging patient encounters leading to moral distress. This is particularly relevant when students are placed in clinical environments where the likelihood of experiencing moral distress is high

Burnout · Clinical Practice · Distress · Medical education · Psychological resilience · Resilience (materials science) · Clinical Psychology · Ethics in medical practice · Healthcare professionals’ stress and burnout · Innovations in Medical Education · Medicine · Nursing · Psychology · Social Psychology

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