HCA healthcare journal of medicine最新文献

{"title":"A Qualitative Follow-Up to a Survey of Program Directors on Wellness Programming at a Large Healthcare Organization: Interviews of High- and Low-Exemplar Programs.","authors":"Sabrina Menezes, Kelsey M Carpenter, Alexander W Marshburn, Stephanie Ramirez, Gregory Guldner, Jessica C Wells, Jason T Siegel","doi":"10.36518/2689-0216.1807","DOIUrl":"10.36518/2689-0216.1807","url":null,"abstract":"<p><strong>Background: </strong>The current research used a qualitative approach to understand which factors facilitate and hinder wellness programming in residency programs.</p><p><strong>Methods: </strong>Program directors identified from a previous quantitative study as having residency programs with notably more or less resident wellness programming than others (ie, high- and low-exemplars, respectively) were contacted. In total, semi-structured interviews were conducted over Zoom with 7 low-exemplars and 9 high-exemplars.</p><p><strong>Results: </strong>The results of this qualitative examination suggest common themes across the 2 exemplar groups, such as wanting more resources for resident wellness with fewer barriers to implementation, viewing wellness as purpose-driven, and seeing wellness as a shared responsibility. There were also critical distinctions between the exemplar groups. Those high in wellness programming expressed more of an emphasis on connections among residents in the program and between the faculty and residents. In contrast, those low in wellness programming described more barriers, such as staffing problems (ie, turnover and lack of faculty wellness) and a lack of integration between the varying levels involved in graduate medical education (GME) operations (ie, between GME programs and sponsoring hospitals, and between GME facilities and the larger health care organization).</p><p><strong>Conclusion: </strong>This study provides insight into program directors' experiences with wellness programming at a large health care organization. The results could point to potential next steps for investigating how the medical education community can improve resident wellness programming.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resident Feedback on Incorporating Reflection Rounds Into a Family Medicine Residency Wellness Curriculum: A Brief Report.","authors":"Stacy Ogbeide, Jasmin Aldridge Hamlett, Inez Isabel Cruz","doi":"10.36518/2689-0216.1776","DOIUrl":"10.36518/2689-0216.1776","url":null,"abstract":"<p><strong>Background: </strong>We sought to understand well-being from the perspectives of residents in a family medicine residency program and to assess the residents' opinions on implementing \"Reflection Rounds\" (RR) to promote wellness and combat burnout through self-reflection. These aims were achieved through descriptive qualitative analysis of a focus group of family medicine residents.</p><p><strong>Methods: </strong>Participation was voluntary and open to all 45 residents in the program. The final participant sample consisted of 14 residents who shared similar characteristics, including level of training and being exposed to similar training stressors. Both a priori and open coding were used for this analysis.</p><p><strong>Results: </strong>An iterative process identified themes based on focus group responses. The residents were in favor of initiating RR and recommended discussion topics unique to family medicine residency. They also identified logistical preferences for this intervention, such as conducting confidential and unrecorded groups, splitting rounds by training year, offering RRs led by a trained facilitator, providing snacks if feasible, and making the RRs available on a regular basis during protected didactic time.</p><p><strong>Conclusion: </strong>This project elucidates how residents are identifying and managing wellness and burnout as well as informs effective ways that family medicine residency programs can incorporate RR into their wellness curriculum.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Resident Led Newsletter Is a Powerful Communication Tool.","authors":"Jonathan Brown, Zuhair Ali, An Dao, Mike Wong, Rajeev Raghavan","doi":"10.36518/2689-0216.1701","DOIUrl":"10.36518/2689-0216.1701","url":null,"abstract":"<p><strong>Background: </strong>Communication with stakeholders for a graduate medical education (GME) program depends on shared visual and written content. Residency training programs are embracing social media as a communication channel. However, curated information that may only be viewed by subscribers or followers is difficult to archive and may appear overwhelming to novice users. An electronic, printable newsletter may be a unique communication tool for training programs to share information among residents, faculty, and hospital administration.</p><p><strong>Methods: </strong>We published a monthly electronic newsletter sent to all residents, teaching faculty, and additional stakeholders in our internal medicine residency program. We conducted an electronic anonymous survey and sent it to all residents in February 2023 and January 2024. The survey consisted of 5 questions to assess the satisfaction level of the newsletter.</p><p><strong>Results: </strong>Sixty of 232 (25.9%) residents completed the survey. Of those, 44 (73.3%) residents were very satisfied regarding overall satisfaction, 39 (65.0%) residents were very satisfied with the overall content, and 42 (70.0%) residents were very satisfied with the timeliness of the information presented. Thirty-six (60%) residents reported the importance of having a resident-led newsletter.</p><p><strong>Conclusion: </strong>We found an overall high satisfaction level in a resident-led newsletter based on a survey completed by residents within our program. Most survey respondents deemed resident leadership crucial for the newsletter. We also received strong positive feedback from key stakeholders ranging from hospital administration to residency applicants.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Feasibility and Impact of an Asynchronous Interprofessional Well-Being Course on Burnout in Health Care Professionals.","authors":"Mari Ricker, Audrey J Brooks, Mei-Kuang Chen, Joy Weydert, Amy Locke, E Kyle Meehan, Paula Cook, Patricia Lebensohn, Victoria Maizes","doi":"10.36518/2689-0216.1778","DOIUrl":"10.36518/2689-0216.1778","url":null,"abstract":"<p><strong>Background: </strong>Well-being initiatives are essential components in fostering an engaged workforce and creating an effective health care ecosystem. Health care professional (HCP) burnout is widespread and has worsened since the COVID-19 pandemic. In 2014, with Health Resources and Services Administration funding support, the Andrew Weil Center for Integrative Medicine created an online course for HCP well-being. It was subsequently studied in medical residents and revised in 2020. In this study, we explore the impact of the course across larger systems, as well as the long-term impact on HCPs.</p><p><strong>Methods: </strong>The Health Care Professional Well-Being course is 4.5 hours of interactive online education that explores personal well-being, promoters and detractors of well-being, and systemic factors that influence the overall impact of well-being in health care systems. Participants were recruited through institutional members of the Academic Consortium for Integrative Medicine and Health and were randomized to either active or waitlist control groups. Assessments were taken pre-course, 1-month post-course, and 6-months post-course in the areas of burnout, compassion, resiliency, and lifestyle behaviors.</p><p><strong>Results: </strong>Burnout measures of depersonalization and emotional exhaustion showed a significant improvement amongst active participants, sustained for 6 months after the course. However, no significant improvement in either the resiliency or the compassion measurements was noted for the active group. Initially, the active group showed improvement in personal accomplishment; however, both groups showed a decline overall. Most noteworthy, a large number of active participants demonstrated adoption of new health-promoting behavior; 95% incorporated at least 1 new lifestyle behavior learned from the course.</p><p><strong>Conclusion: </strong>This study of a brief, asynchronous, online well-being course with interprofessional HCPs, demonstrates that the course is associated with improvement in individual burnout measures and can educate HCPs about healthy behaviors and a framework for professional engagement.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise Is a Vital Sign.","authors":"Megan Dannemiller, Anthony Shadiack, Marvin Sineath, Andrew Baird, Marc Poirier, Kevin Thomas, Michael G Flynn","doi":"10.36518/2689-0216.1829","DOIUrl":"10.36518/2689-0216.1829","url":null,"abstract":"<p><p>Description In this review, we argue that exercise (physical activity) be monitored as a vital sign since no other basic sign or symptom provides as much information about a patient's health status. The influence of regular exercise on patient health is indisputable, with strong evidence to show the power of exercise to mitigate chronic disease and improve overall health. Several simple tools, such as Physical Activity as a Vital Sign and Exercise as a Vital Sign are available to assess patient physical activity. When properly applied, there is evidence to support the efficacy of these tools, but there are barriers that prevent broad inclusion in primary care, among which are time and provider knowledge. In our review, we also discussed the value of physician-led lifestyle discussions with patients and found they view these discussions favorably. There is also evidence that physicians who exercise are more likely to have these lifestyle discussions with their patients, but the proportion of physicians who exercise regularly is fairly low. We believe physicians' awareness of their patients' sedentary lifestyles should prompt a prescription to increase physical activity, but additional in-clinic support and community resources need to be in place for patients to get a regular dose.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of a 4-Domain Wellness-Initiative Curriculum on Internal Medicine Resident Physicians.","authors":"Esha Vallabhaneni, Luigi Cubeddu, Ryan Petit, Fernando Poli, Premal Patel, Cynthia Rivera","doi":"10.36518/2689-0216.1779","DOIUrl":"10.36518/2689-0216.1779","url":null,"abstract":"<p><strong>Background: </strong>There is a trend toward fostering well-being, or the state of being happy and healthy, within the medical community. Historically, resident physicians have faced high rates of distress during training. A structured well-being curriculum in residency programs may shift residents' mindsets from survival and resilience to one centered on purpose, engagement, and joy.</p><p><strong>Methods: </strong>An original well-being curriculum was administered to residents in person at a single institution every 5 weeks for approximately 10 well-being workshops, totaling around 20 hours of curriculum exposure during every academic year. The well-being curriculum was divided into 4 domains: cognitive distortions and problematic mindsets, mindfulness and meditation, creative outlets, and self-compassion.Residents exposed to at least 1 year of the well-being curriculum were asked to answer an anonymous survey. Four questions were asked for each of the 4 domains. The first and second questions asked how familiar they were with the topic before and after the workshops on a scale of 1-5 of familiarity. The third and fourth questions asked how much the knowledge acquired influenced their professional and personal life on a scale of 1-5 of influence.</p><p><strong>Results: </strong>Before curriculum exposure, the average for moderate or higher levels of knowledge across all domains was 22.7%, which improved to 77.3% after curriculum completion. Overall, 58.6% of participants felt the knowledge of the domains was moderately or extremely influential in their professional lives and 83.6% in their personal lives. There were no significant differences between post-graduate year 2 and post-graduate year 3 residents for any domains examined before and after the wellness workshops.</p><p><strong>Conclusion: </strong>A 4-domain well-being curriculum practiced in a group setting positively impacted participating residents in their personal and professional lives. Further studies need to be performed on a larger scale to assess if the curriculum fits the needs of the broader medical community.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Well-Being and Leadership Within the Emergency Department.","authors":"Jacob T Berg, Thomas Matese, Dennis Anthony Cardriche, David Hotwagner","doi":"10.36518/2689-0216.1781","DOIUrl":"10.36518/2689-0216.1781","url":null,"abstract":"<p><p>Description This article looks at well-being and the role of leadership from the perspective of emergency medicine. The importance of leadership within the emergency department (ED), emergency medicine writing at large, and the prevention of burnout and compassion fatigue cannot be overstated. This article looks at the need for more research and measured interventions within the ED. It also highlights some measures that could be taken to help improve well-being from a leadership perspective to improve patient safety and outcomes within the ED.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Motivates You?","authors":"Mohamad S Saad","doi":"10.36518/2689-0216.1840","DOIUrl":"10.36518/2689-0216.1840","url":null,"abstract":"<p><p>Description For over 100 years, we have tried to understand how human motivation works. Although various theories have been developed and different experiments have been conducted to explain motivational drive, we have realized that extrinsic motivation factors, such as rewards and punishment, and financial incentives are not the answers. More important and central to motivation is nourishing our innate human need to be autonomous, competent, and to relate to our organizational culture. All of us need to understand the story of motivation because, as dire as our need for high-quality motivation is, high-quality motivation remains an asymptote.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multi-Wave Study of Factors Associated With Resident Engagement, Depression, Burnout, and Stay Intent.","authors":"Anne M Brafford, Brendon Ellis, Greg Guldner, Gabrielle Riazi, Xitao Liu, Jessica C Wells, Jason T Siegel","doi":"10.36518/2689-0216.1837","DOIUrl":"10.36518/2689-0216.1837","url":null,"abstract":"<p><strong>Background: </strong>Many studies have documented the epidemic of mental ill-being among resident physicians, but fewer have focused on mental well-being or on guiding intervention design to make progress toward positive change in residency programs to support resident thriving. Informed by the job demands-resources model (JD-R) and positive psychology, the current study examines 4 potential predictors of residents' ill-being (burnout, depression) and well-being (engagement, stay intent) that are malleable and thus capable of change through intervention: psychological capital (PsyCap), supervising physicians' autonomy-supportive leadership style (ASL), social support, and meaningful work.</p><p><strong>Methods: </strong>Three waves of data were collected between November 2017 and September 2018 at a large hospital system in the United States. Due to participant response rates, we were unable to conduct a planned longitudinal analysis. Therefore, for each wave, Bayesian regression analyses were used to examine cross-sectional relationships between the 4 predictors and each outcome.</p><p><strong>Results: </strong>Although findings varied across the study's 3 waves, the outcomes were largely as expected. With only 1 exception (depressive symptoms in Wave 2), meaningful work significantly predicted all outcome variables in the expected direction across all 3 waves. PsyCap significantly predicted burnout, depressive symptoms, and engagement in the expected direction across all 3 waves. ASL significantly predicted engagement in the expected direction across all 3 waves, as well as depressive symptoms and stay intent in 2 waves, and burnout in 1 wave. Social support significantly negatively predicted depressive symptoms in all 3 waves and burnout in 1 wave.</p><p><strong>Conclusion: </strong>Applying the JD-R framework and a positive psychology lens can open new pathways for developing programming to support resident thriving. Meaningful work, PsyCap, ASL, and social support all significantly predicted 1 or more outcomes related to resident thriving (burnout, depression, engagement, stay intent) across all 3 waves. Thus, this study provides theoretical and practical implications for future intervention studies and designing current programming for resident thriving.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creating and Supporting Well-Being in Graduate Medical Education.","authors":"Gregory Guldner","doi":"10.36518/2689-0216.1984","DOIUrl":"10.36518/2689-0216.1984","url":null,"abstract":"<p><p>Description Graduate medical education strives to create the next generation of skillful and compassionate physicians for our nation. Yet, research shows a high degree of depression, anxiety, workplace burnout, lack of engagement, and general dissatisfaction with the work and learning environment for many of these dedicated individuals. We present this special issue related to creating and supporting well-being in the graduate medical education community.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}