The second victim phenomenon in medical education: Development of learning objectives based on the National Competency-based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM).

Background: The second victim phenomenon describes the psychological, cognitive and physical reactions of healthcare professionals who are directly or indirectly involved in adverse patient events or errors and are themselves impaired as a result. Common symptoms include anxiety, guilt, grief, depression and burn-out, which can significantly restrict their ability to work. Surveys in German-speaking countries show that the prevalence of the second victim phenomenon is as high as 89% across all healthcare professions. Objective: This paper aims to synthesise learning objectives pertaining to the second victim phenomenon from the current literature and thus provide a basis for training medical students. Methods: Design: Qualitative synthesis of relevant categories using "best fit" framework synthesis based on the European Researchers' Network Working on Second Victims. Data collection: Literature search in PubMedCentral, MEDLINE, Cochrane and CINAHL based on the categories. Data analysis: Qualitative document analysis according to Mayring with synthesis of the learning objectives and definition of the depths of competency: According to the depths of competency in knowledge, practical knowledge, and practical skills, based on the taxonomy of the National Competency-based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM). Results: The analysis resulted in the definition of a framework catalogue with four subcategories: I: Basic concepts and definition of the second victim phenomenon, II: Symptoms of the second victim phenomenon and need for support, III: Intervention options, and IV: Contextualisation of the second victim phenomenon in the broader context of employee welfare. These categories were assigned to seven areas of knowledge and, based on this, seven learning objectives with their respective depths of competence were defined. Conclusion: In this study, seven evidence-based learning objectives concerning the second victim phenomenon were defined for medical students and systematically integrated into the NKLM's taxonomy. The results provide a structured basis for anchoring this topic into the curriculum in order to impart knowledge about the second victim phenomenon early on and minimise long-term, negative consequences for healthcare professionals.