驻地健康：历史叙事回顾。

IF 2.6 3区医学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Surgical Education Pub Date : 2024-10-07 DOI:10.1016/j.jsurg.2024.09.013

Jacob Leung BA , Brian Tao BA , Dhanesh D. Binda MD , Maxwell B. Baker MSc , Ansel Jhaveri MD , Mark C. Norris MD

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引用次数: 0

摘要

导言：随着医学科学和教育的发展，美国的住院医师培训结构也发生了重大变化。这些变化在加强医学培训的同时，也带来了挑战，尤其是在住院医师的健康方面。住院医师的健康对患者护理和医疗保健系统至关重要。本综述旨在概述住院医师培训的历史趋势，重点关注住院医师健康的演变及其相关挑战：方法：我们对医学住院实习的演变和挑战进行了叙述性综述，重点关注住院医师的健康。2024 年 1 月 25 日，在 PubMed、Web of Science 和 Google Scholar 上进行了详尽的文献检索。搜索使用了与住院医师培训、健康和教育改革相关的关键词。根据相关性和有力证据对文章进行筛选，并将信息按主题分类，进行叙述性综合：搜索结果显示有 57 篇出版物符合纳入标准。历史趋势揭示了从学徒模式到正规化培训计划的转变，每个阶段都给住院医师健康带来了独特的挑战。弗莱克斯纳报告》对医学教育标准化的影响、现代住院医师培训项目的兴起以及对职业倦怠这一重要问题的认识，都是关键的发展。政策的变化、技术的影响以及 COVID-19 的流行进一步影响了住院医师培训和健康。研究强调，有必要采取干预措施来解决职业倦怠问题并促进健康，不同专业和机构采取的方法各不相同：自 20 世纪 70 年代以来，住院医师职业倦怠问题日益受到关注，医学、技术的进步以及 COVID-19 大流行等近期全球事件加剧了这一问题。尽管人们的认识有所提高，但仍有必要在住院实习期间解决职业倦怠问题并促进健康。有必要开展进一步的研究，以制定有效的干预措施并调整培训内容，满足住院医生不断变化的需求。

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Residency Wellness: A Historical Narrative Review

INTRODUCTION

The structure of medical residency in the United States has experienced significant changes, paralleling advances in medical science and education. While these changes have enhanced medical training, they have introduced challenges, particularly in resident wellness. The well-being of residents is critical for patient care and the healthcare system. This review aims to provide an overview of the historical trends in medical residency, focusing on the evolution of resident wellness and its associated challenges.

METHODS

A narrative review was conducted, examining the evolution and challenges of medical residency with an emphasis on resident wellness. An exhaustive literature search on January 25, 2024 was conducted across PubMed, Web of Science, and Google Scholar. The search utilized keywords related to medical residency, wellness, and educational reforms. Articles were selected based on relevance and robust evidence, and information was organized into thematic categories for narrative synthesis.

RESULTS

The search yielded 57 publications that met the inclusion criteria. Historical trends revealed a shift from an apprenticeship model to formalized training programs, with each phase bringing unique challenges to resident wellness. The Flexner Report's influence on standardizing medical education, the rise of modern residency programs, and the recognition of burnout as a significant issue were key developments. Policy changes, technological impacts, and the COVID-19 pandemic have further shaped residency training and wellness. Studies highlight the need for interventions addressing burnout and promoting wellness, with varied approaches across specialties and institutions.

CONCLUSION

Residency burnout has been a growing concern since the 1970s, exacerbated by advancements in medicine, technology, and recent global events like the COVID-19 pandemic. Although awareness has increased, the need remains to address burnout and promote wellness during residency. Further research is warranted to develop effective interventions and adapt training to meet the evolving needs of residents.

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来源期刊

Journal of Surgical Education EDUCATION, SCIENTIFIC DISCIPLINES-SURGERY

CiteScore

5.60

自引率

10.30%

发文量

261

审稿时长

48 days

期刊介绍： The Journal of Surgical Education (JSE) is dedicated to advancing the field of surgical education through original research. The journal publishes research articles in all surgical disciplines on topics relative to the education of surgical students, residents, and fellows, as well as practicing surgeons. Our readers look to JSE for timely, innovative research findings from the international surgical education community. As the official journal of the Association of Program Directors in Surgery (APDS), JSE publishes the proceedings of the annual APDS meeting held during Surgery Education Week.