Medical students' views on the value of trigger warnings in education: A qualitative study

Abstract

Background: Trigger warnings-advance notification of content so recipients may prepare for ensuing distress-feature in discussions in higher education. Students' expectations for warnings in some circumstances are recognised, and some educators and institutions have adopted use. Medical education necessitates engagement with potentially distressing topics. Little is known about medical students' expectations regarding warnings in education.Methods: All students from a 4-year graduate-entry UK medical degree programme were contacted via digital message outlining study details and were openly sampled.Qualitative methodology was chosen to explore participant expectations, experiences and meanings derived from experiences. Students participated in semistructured interviews exploring perspectives on functions, benefits and drawbacks of trigger warnings in classroom-based medical education. We analysed interview transcripts using thematic analysis.Results: Thirteen semi-structured, qualitative interviews were undertaken. Themes in the following areas were identified: (1) students' experiences influence understanding of trauma and trigger warnings, (2) warnings as mediators of learning experiences, (3) professional responsibilities in learning, (4) exposure to content, (5) professional ethos in medical education and (6) how to issue trigger warnings.Students recognised the term 'trigger warning', and that warnings are an accommodation for those affected by trauma. Students' conceptualisation of warnings was influenced by personal experiences and peer interactions both within and outside education. Students expressed both support and concerns about use of warnings and their ability to influence learning, assuming of responsibility and professional development.Discussion: Diverse student opinions regarding warnings were identified. Most students suggested that warnings be used prior to topics concerning recognised traumas. Incremental exposure to distressing content was recommended. Students should be supported in managing own vulnerabilities and needs, while also experiencing sufficient formative exposure to develop resilience. Greater understanding of trauma prevalence and impacts and underpinnings of warnings amongst

Response to: Response triggered: Trigger warnings, a necessity or nuisance

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We read with interest Badawy and Chowdhury's 1 comments on our study of graduate-entry medical students' views on the value of trigger warnings. 2 We agree that novel transition experiences faced by younger, school-leaver medical students can underpin high levels of emotional distress, which may not typically be experienced by graduate-entrants.We in no way wish to underestimate the impacts of these transitions.In considering the issue of education 'triggering' prior life events, we

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Student support services: Perceptions and recommendations for the next generation

“…Similarly, the development of content, or trigger, warnings may be warranted for some curricular topics, along with the establishment of support protocols for students who may have strong responses to particular content. 14,17 Acute test anxiety was reported by 71.6 percent of respondents, and most did not seek out assistance from student support services to manage their test anxiety. Cultural factors can play a role in student utilization of resources, particularly mental health care.…”

Response triggered: Trigger warnings, a necessity or nuisance

“…the value of trigger warnings in their medical education. 1 We reflected on their findings as school-leaver medical students who have observed the increasing usage of trigger warnings during our training.…”

“…2 Yet Nolan and Roberts state that school-leavers lack life experience, professional maturity and resilience. 1 Rates of depression are highest in the first year of medical school, 3 and for many school-leavers, this period is the most mentally challenging. They learn to cope with the jump in difficulty of higher education at the same time as experiencing separation from their familial support networks.…”

“…As a result, avoidance of trigger warnings was a popular opinion amongst postgraduate students as Nolan and Roberts's participants identified needs to develop professional resilience and better simulate reality. 1 However, such avoidance may jeopardise the safe learning environment that medical school provides, particularly for younger students.…”