A Context-Rich Look at Medical Trainees’ Emotion Formation and Regulation

• In Event: A Comprehensive Look at Emotion Formation and Regulation Across Different Contexts With Various Methodologies

Abstract

Introduction and Theoretical Framework
Emotions can help or hinder performance across academic achievement contexts, which makes regulating them crucial (Harley et al., 2019; Harley & Pekrun, 2024). All attempts to regulate our emotions are not equally effective, however (Losenno et al., 2020), especially when we consider the situation and to-be regulated emotion (Rottweiler et al., 2023). Educational research has tended to focus on the strategies learners use to regulate their emotions with insufficient attention to the emotions targeted and emotion regulation (ER) goals (Tamir, 2009) that motivated the ER strategy.
Previous preliminary research revealed that medical trainees overwhelmingly reported selecting instrumental goals (72%) and used either attention allocation (44.6%) or situation modification strategies (38%) to manage negatively-valenced, activating emotions (74%; Harley et al., 2024). These findings left much unanswered, however, according to the ER in Achievement Situations Model (Harley et al., 2019) which integrates and extends Gross’ (2015) process model of ER and Pekrun’s (2006) control-value theory of achievement emotions. We help address gaps in the context of emotion generation and regulation by sharing frequency results and two contrasting case examples.
Methods and Data
We report findings from a mixed-methods, observational study that includes 105 medical trainees (residents) from a North American University. Medical trainees completed a high-fidelity medical simulation in teams to diagnose and save the life of a patient. Participants completed a newly developed Simulation Emotion Regulation Questionnaire (SimERQ; Figure 1), modified and extended from Webster & Hadwin (2012, 2014). In this paper, we drew on all items from the SimERQ: see Table 1. We also selected two contrasting case examples that represent (1) a common and reportedly ‘successful’ ER profile versus (2) an uncommon and ‘unsuccessful’ ER profile based on the frequency analyses (see Figures 1,2).
Results and Significance
Examination of frequencies across questions revealed that most trainees reported performing “okay” (57%) or “well” (28%) but were more generous with their ratings of accomplishing a personal goal for the simulation (80%) and their team’s performance. As expected from this dataset where most participants reported targeting negatively-valenced, activating emotions (74%), the majority attempted to decrease the intensity of their targeted emotion (68%) or switch it to something else (21%). Interestingly, only 58% successfully decreased the intensity of the emotion and 14% switched their emotional state. While 64% of residents reported their ER strategy as being helpful to accomplish their goal for the simulation, 30% reported that their ER strategy was unhelpful or detrimental. Further, only 56% reported that their ER strategy made the simulation a little or a lot easier, whereas nearly 30% reported it did not make completing easier or harder, and nearly 15% reported that it made it harder. These findings, including our contrasting cases, reveal that many medical trainees would benefit from support regulating their emotions to mitigate challenges doing so and reports that efforts are often unhelpful or even detrimental. Physiological response and coded SRL behavior of the contrasting cases will be included in the full presentation.

Authors

• Jason Matthew Harley, McGill University

• Matthew Moreno, University of Central Florida

• Keerat Kaur Grewal, McGill University

• Sayed Azher, McGill University

• Reinhard Pekrun, University of Essex