Medical student perceptions of physical and emotional safety before and after 5-week mental health placements

Objective: Understanding whether medical students feel safe in mental health placements is important to delivering effective and engaging training experiences. Method: Second year students completed anonymous online surveys before (n = 37) and after (n = 41) mental health placements, to gather qualitative and quantitative data about their sense of physical and emotional safety, and factors that positively and negatively influenced their experiences. Data were analysed using chi square and content analysis. Results: There was a disparity between students' expectations of physical and emotional safety before placements and their actual experience. Following placement, no students reported that they felt physically 'unsafe' or 'very unsafe'. Conversely, over 20% of students indicated that they had felt emotionally unsafe during their placement. When asked to compare their expectations prior to placement with their actual experience, over 13% felt 'much less safe' emotionally, where no participants felt 'much less safe' physically. Qualitative content identified included exposure to patients' tragic life stories, aggression, the physical ward environment and adequacy of supports. Conclusions: The distinction between physical and emotional safety is a valuable framework through which to understand the student experience of clinical placements in psychiatry and to seek to best support students. The data provide rich insight into students' experiences, particularly emotional challenges, on psychiatry wards.