Feeling the responsibility: Exploring the emotional experiences of final-year medical students when carrying out clinical tasks

Abstract

Purpose

The concept of Entrustable Professional Activities (EPA) is increasingly used to operationalize learning in the clinical workplace, yet little is known about the emotions of learners feeling the responsibility when carrying out professional tasks.

Methods

We explored the emotional experiences of medical students in their final clerkship year when performing clinical tasks. We used an online reflective diary. Text entries were analysed using inductive-deductive content analysis with reference to the EPA framework and the control-value theory of achievement emotions.

Results

Students described a wide range of emotions related to carrying out various clinical tasks. They reported positive-activating emotions, ranging from enjoyment to relaxation, and negative-deactivating emotions, ranging from anxiety to boredom. Emotions varied across individual students and were related to the characteristics of a task, an increasing level of autonomy, the students’ perceived ability to perform a task and the level of supervision provided.

Discussion

Emotions are widely present and impact on the workplace learning of medical students which is related to key elements of the EPA framework. Supervisors play a key role in eliciting positive-activating emotions and the motivation to learn by providing a level of supervision and guidance appropriate to the students’ perceived ability to perform the task.

Keywords:

• Emotions
• control value theory
• entrustable professional activities
• workplace-based learning

Acknowledgements

The authors would like to thank Tanja Hitzblech and Asja Maaz for their valuable contributions to the design of the study and the questionnaire. The authors would also like to thank all the participants for taking part and sharing their experiences.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Ethical approval

The study protocol received approval from the Charité ethics committee on November 27, 2020 (no. EA1/342/20).

Glossary

Emotional valence: The term emotional valence refers to the designation of an emotion as positive (i.e. experienced as attractive, ‘good’ or pleasurable) or negative (i.e. experienced as dislike, aversive, ‘bad’ or unpleasant). Shuman V, Sander D, Scherer KR. Levels of valence. Front. Psychol. 2013 May;4:261. doi:10.3389/fpsyg.2013.00261.

Inhibition: The term inhibition refers to the process of withholding behavioural impulses, including response selection. It can happen consciously or unconsciously. American Psychological Association (n.d.). Inhibition [Internet]. APA Dictionary of Psychology; 2023 [cited 2023 Oct 24]. Available from: https://dictionary.apa.org/inhibition

Additional information

Funding

The study was partially funded by the foundation ‘Bundesministerium für Bildung und Forschung’ as part of the Initiative ‘Hochschulpakt’ (authors AF and MA), and partially through the foundation ‘Robert Bosch Stiftung’ founding the Project ‘INTER-M-E-P-P’ within the programme ‘Operation Team’ (author RB). The funding body had no influence on the design of the study, on the collection, analysis, and interpretation of the data or on the preparation of the manuscript.

Notes on contributors

Miriam Alexander

Miriam Alexander, Dipl.-Psych., is a psychologist, doctoral fellow and research associate, Dieter Scheffner Center for Medical Education and Educational Research, Dean’s Office of Study Affairs, Charité – Universitätsmedizin Berlin, Berlin, Germany.

Ronja Behrend

Ronja Behrend, Dr. rer. medic., is a research associate, semester coordination, Dean’s Office of Study Affairs, Charité – Universitätsmedizin Berlin, Berlin, Germany.

Anne Franz

Anne Franz, Dr. rer. medic., is an educational scientist and research associate, Dieter Scheffner Center for Medical Education and Educational Research, Dean’s Office of Study Affairs, Charité – Universitätsmedizin Berlin, Germany.

Harm Peters

Harm Peters, Dr. med., M.D., MHPE, is Professor of Medical Education and Director of the Dieter Scheffner Center for Medical Education and Educational Research, Dean’s Office of Study Affairs, Charité – Universitätsmedizin Berlin, Germany.