The Second Victim Phenomenon Among Paramedic Trainees

Results of the First German Cross-Sectional Study on Prevalence, Symptom Burden, and Support Needs

Abstract

Background: The Second Victim Phenomenon describes the psychological and emotional distress experienced by healthcare professionals following critical incidents, unexpected patient harm, or medical errors (Wu, 2000). While the phenomenon has been investigated across various healthcare professions, evidence regarding paramedic trainees remains scarce.

Objective: This study aimed to investigate the prevalence of the Second Victim Phenomenon, the associated symptom burden, and the perceived usefulness of support measures among paramedic trainees in Baden-Württemberg, Germany.

Methods: A quantitative cross-sectional study was conducted using an anonymous online survey. The target-group-specific instrument was based on a modified version of the SeViD questionnaire (Second Victims in Germany). Prior to the main survey, the adapted version was pretested with ten individuals (five students and five colleagues). Participants were recruited through twelve paramedic training schools in Baden-Württemberg. Internal consistency was Cronbach’s α = .855 for the 22 symptom items and α = .819 for the 11 support-measure items. The survey assessed sociodemographic characteristics, experiences related to the Second Victim Phenomenon, triggering events, symptoms, and perceived usefulness of support measures. Statistical analyses included descriptive statistics, binomial testing, Wilcoxon signed-rank testing, Mann–Whitney U testing, and chi-square testing.

Results: Data from 94 paramedic trainees were included in the analysis. Overall, 44.7% reported at least one Second Victim experience. The most frequently reported triggering events were cardiopulmonary resuscitations and patient deaths (21.4% each), followed by perceived treatment errors (19.1%). The most common symptoms were feelings of guilt (73.8%), self-doubt (69.1%), and concentration difficulties (57.1%). Prior to the survey, 92.6% of participants were unfamiliar with the term Second Victim. Psychosocial support measures were rated as significantly more helpful than organizational and administrative support measures.

Discussion: The findings indicate that Second Victim experiences are common during paramedic training and are associated with relevant psychological distress. The low level of awareness of the phenomenon also points to deficits in sensitization and curricular integration. The findings therefore emphasize the importance of early awareness-building, structured debriefing, and reliable support services during paramedic training.

Conclusion: Paramedic training schools, emergency medical service training sites, and emergency medical service organizations should integrate the Second Victim Phenomenon into their curricula and establish structured debriefing, peer-support programs, and professional support services. Practice instructors play a central moderating role in this process.