Can Stress Be Good for Learning? Pediatric Resident Perspectives on the Beneficial Influence of Stress on Learning and the Role of the Supervisor

Abstract – Purpose – Stress is a ubiquitous phenomenon in medical training, exerting beneficial and harmful effects on learning. The medical education literature focuses primarily on harmful effects. By overlooking beneficial effects, supervisors may miss opportunities to harness the educational value of stress. This study explores pediatric trainees’ perspectives on (1) stressors that lead to learning outcomes, (2) the learning outcomes themselves, and (3) the supervisors’ role in the stress pathway. Method – Using a stress learning pathway as a guiding framework, the authors conducted a qualitative study in which they interviewed residents from the University of Washington Pediatrics Residency Program from August to October 2023. The authors analyzed interview transcripts using template analysis, creating a template that included codes based on the stress pathway model and codes derived from the data. Using the template, the authors coded the transcripts and developed themes and subthemes. Results – Twenty residents across 3 training years (postgraduate years 1–3) participated. All participants shared examples of when stressful experiences served as catalysts for valuable learning outcomes. Six themes were identified from the participants’ narratives: (1) work-related stressors can lead to valuable learning; (2) valuable learning can result from stressors; (3) supervisors are sources of stress when they provide autonomy, hold learners accountable, and set high expectations; (4) supervisors serve as modulators of other stressors that are inherent to being a trainee; (5) senior residents play an integral role in junior residents’ stressful experiences more so than attending physicians; and (6) supervisors can use strategies to effectively harness the learning potential of stressors. Conclusions – This study sheds light on the beneficial influence of stress on learning in medical education. Trainees believe that, if properly supported by supervisors, stress can yield valuable learning opportunities. Next steps include obtaining supervisors’ perspectives and elucidating supervisor behaviors that maximize learning under stressful conditions.