Exploring the impact of overnight call stress on anaesthesiology senior residents’ perceived ability to learn and teach in an Asian healthcare system: A qualitative study

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Acute stress can influence clinical performance, reasoning and decision-making. Our Anaesthesiology senior residents encounter physical and psychological stress during the overnight calls. To date, the impact of these stressors on their ability to learn and to supervise is unclear. We explored the nature of these stressors, and their influence on our trainees’ perceived learning and teaching.We conducted this qualitative study from August 2017 to February 2018. We adopted the constructivist approach to explore the participants’ experiences, and used focus group interviews to derive the information. An inductive and iterative process of information collection, analysis and thematic classification was employed. 7 senior residents participated in the interviews.The participants experienced high levels of stress during the calls. Four categories of stressors were identified: (1) emergency work, (2) physical and mental exhaustion, (3) concerns over supervisory roles and incurring clinical risks, and (4) concerns with appearing deficient. Participants’ perceived learning was negatively affected, and associated with emotions of frustration, self-doubt, and guilt. Teaching of junior residents was perceived to be impacted negatively. Patient outcomes may be affected by learner demotivation and cognitive errors. We identified the physiological and safety needs of these learners and suggested strategies to overcome them.Stressors encountered during overnight calls can influence the learning and teaching of trainees. Strategies should be implemented to reduce the impact of these stressors and to enhance the learning experience of trainees, and further work should be done to determine the effectiveness of such measures.