"Don't worry, you can trust me": Indicators of the role of trust in residents' reflective writing: Presenter(s): Allen Shaughnessy, Tufts University School of Medicine, United States; Ashley Duggan, Boston College, United States. (April 2023)

• Record Type: Journal Article
• Authors: O'Reilly-Jacob, Monica; Vicini, Andrea
• Is Part Of: Patient education and counseling. Volume 109(2023)Supplement
• Page Start: 54
• Publication Date: 2023-04
• Subjects: Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2022.10.131
• Languages: English
• ISSNs: 0738-3991

Abstract

Abstract : Background: Trust occurs when a person feels they can be vulnerable to others because of the sincerity, benevolence, truthfulness and sometimes the competence they perceive within a specific context. This project examines the various types of trust captured in written reflections of family medicine residents. Our goal is to understand the roles trust plays in residents' self-examination and to develop a framework for developing further understanding of trust in healthcare. Methods: We analyzed 767 reflective writings of 33 residents submitted anonymously, to identify explicit uses of the word "trust" but also explicit or implicit indicators attention to trust or relationship development. Two authors independently inductively coded the entries. Three authors developed a final coding structure that was checked against the entries. These codes were sorted into categories from which themes were developed. Findings: We identified 102 written reflections contained one or more indicators of trust. These codes were compiled into five code categories: Trust of self/trust as the basis for confidence in their decision making; Trust of others in the medical community; Trust of the patient and its effect on themselves; Assessment of the trust of them exhibited by the patient; and, Assessment of the effect of the patient's trust on the patient's behavior. Discussion: Trust is both relationship-centered and institutionally situated. Trust is a process, built on reciprocity. There is tacit acknowledgement of the interplay among what the residents do is good for the patient, good for themselves, and good for the medical institution. A focus on moments in which trust is experienced or missed, as well as on types of trust, misses this complexity. A greater awareness of how trust is present or absent could lead to a greater understanding of what has beneficial effects on physicians' performance, personal and professional satisfaction, and improved quality in patients' interactions.