Educating Anesthesiology Residents and Their Support Persons to Improve Understanding and Increase Wellness: A Multisite Study.

Susan M Martinelli,Thanh N Tran,Courtney L Canter,Di Hu,Robert S Isaak,Farzana Afroze,Teresa A Mulaikal,Beth Ladlie,Ankit Jain,Chelsea Willie,David L Stahl,Tekuila R Carter,Lara Zisblatt,Amie L Hoefnagel,Julie M Marshall,Stephen Collins,Ryan J Keneally,Timothy W Martin,Fei Chen
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Abstract

BACKGROUND Burnout remains prevalent among anesthesiology residents. Contributing workplace factors include limited control over scheduling, unpredictable hours, critical patient care needs, and other residency challenges. The Family Anesthesia Experience (FAX) is a program designed to educate residents and their support persons on wellness and residency demands. The focus of this multisite study was to evaluate the impact of FAX on first year clinical anesthesiology (CA1, ie, PGY2s) residents' wellness. METHODS This was a prospective evaluation study involving 15 US anesthesiology residency programs, 13 of which completed FAX. CA1 wellness was evaluated through surveys assessing perceived stress as the primary outcome, with exploratory outcomes including burnout, depression, psychological wellness, and social support. Additionally, changes in support persons' understanding and knowledge of residency demands were tracked over time. The study included a historical control group of 302 CA1s (2019-2021) who did not participate in FAX, and an intervention group of 88 CA1s that participated in FAX (2021-2022). Statistical analyses compared changes in metrics between groups using linear mixed models and generalized linear models. RESULTS Significant reductions in perceived stress were observed in the intervention group at 6 months post-FAX (mean change = -2.14, 95% CI, -3.95 to -0.34; P =.021, effect size = 0.58) relative to the control group, but there was no sustained difference at 12 months. Compared to the control support persons, intervention support persons reported increased understanding of residency demands, with significant improvements at 6 (mean change = 2.80, 95% CI, 1.12-4.48; P =.001, effect size = 0.77) and 12 (mean change = 2.59, 95% CI, 0.12-5.05; P =.039, effect size = 0.71) months. Improvement in support persons' understanding did not predict changes in CA1 wellness outcomes. First generation physician residents reported lower family support at baseline but showed significant improvements in family support at 6 months (mean change = 3.05 points; 95% CI, 0.25-5.84; P =.033; effect size = 1.23) compared to their non first generation peers. CONCLUSIONS FAX participation was associated with reduced perceived stress in residents up to 6 months post-intervention. First generation physicians experienced greater improvements in perceived family support compared to their non first generation peers. Our findings suggest that resident wellness may be enhanced by engaging both residents and their support persons in an educational wellness program that outlines the professional expectations and demands of anesthesiology residency training.
教育麻醉科住院医师及其辅助人员增进了解和增进健康:一项多地点研究。
背景:职业倦怠在麻醉科住院医师中仍然普遍存在。工作场所的影响因素包括对日程安排的有限控制、不可预测的工作时间、关键病人的护理需求和其他住院医师的挑战。家庭麻醉体验(FAX)是一个旨在教育住院医师及其支持人员关于健康和住院医师需求的项目。本多中心研究的重点是评估FAX对第一年临床麻醉学(CA1,即PGY2s)住院医师健康的影响。方法:这是一项前瞻性评估研究,涉及15个美国麻醉住院医师项目,其中13个完成了FAX。CA1健康通过调查评估感知压力作为主要结果,探索性结果包括倦怠、抑郁、心理健康和社会支持。此外,随着时间的推移,赡养人员对居住需求的理解和知识的变化也被跟踪。该研究包括未参加FAX的302名ca1(2019-2021)的历史对照组和88名参加FAX的ca1(2021-2022)的干预组。统计分析使用线性混合模型和广义线性模型比较组间指标的变化。结果干预组在传真后6个月的感知压力较对照组显著降低(平均变化= -2.14,95% CI, -3.95 ~ -0.34; P = 0.021,效应量= 0.58),但在12个月时无持续差异。与对照支持人员相比,干预支持人员报告对住院需求的理解有所增加,在6个月(平均变化= 2.80,95% CI, 1.12-4.48; P = 0.001,效应量= 0.77)和12个月(平均变化= 2.59,95% CI, 0.12-5.05; P = 0.039,效应量= 0.71)时有显著改善。支持人员理解的改善并不能预测CA1健康结果的变化。第一代住院医师在基线时报告的家庭支持较低,但与非第一代同行相比,在6个月时家庭支持有显著改善(平均变化= 3.05点;95% CI, 0.25-5.84; P = 0.033;效应值= 1.23)。结论参与sfax与干预后6个月居民感知压力的减少有关。与非第一代医生相比,第一代医生在感知家庭支持方面有了更大的改善。我们的研究结果表明,住院医师的健康可以通过让住院医师和他们的支持人员参与一个健康教育计划来提高,该计划概述了麻醉住院医师培训的专业期望和要求。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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