外科训练中的正念（MiST）：外科住院医师正念课程的修改

IF 2.6 3区医学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Surgical Education Pub Date : 2024-11-30 DOI:10.1016/j.jsurg.2024.103351

Elizabeth Miazga MDLLM , Brenna E. Swift MD, MSc (HSED), MASc , Madalina Maxim MD , Monica Pearl MD , Anna R. Gagliardi PhD , Janet Bodley MD Med , Michèle Farrugia MSc, MD Med , Hava Starkman MD , Anna Kobylianskii MD , Julie Maggi MD , Carol-Anne Moulton MD, PhD , Dana Soroka MD , Andrea N. Simpson MD, MSc

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引用次数: 0

摘要

住院医生经历了许多工作和个人压力，使其难以在手术室集中注意力，对学习和手术表现产生负面影响。以正念为基础的认知疗法可以减少焦虑，提高记忆力和学习能力。本研究旨在为外科住院医师创建一个可行且理想的改良正念课程。设计：这是一项前瞻性队列研究，采用多种方法设计，评估为忙碌的外科受训者量身定制的为期12周的改良正念课程，包括每周30分钟的小组会议和每天15分钟的家庭练习。主要结果是方案的可行性和可取性。焦点小组探讨了正念技术如何在手术室中使用。次要结果在干预前和干预后设计中测量，使用有效的评估量表评估手术表现、焦虑、信心和倦怠。结果测量在基线、疗程结束后和干预后3个月收集。学术产科和妇科住院医师计划。参与者：邀请多伦多大学研究生2-5年级的妇产科住院医师参加“外科正念训练”。结果61名符合条件的居民中有12人（20%）参加了该计划，8人（67%）完成了课程。有统计学意义的焦虑减少(p <；0.001)和手术信心的增加（p = 0.007）。倦怠和手术表现评估没有变化。专题分析发现，正念工具是有益的，并且在干预后3个月，参与者经常在手术室中持续使用正念工具。参与正念课程的最大障碍是时间。参与者认为住院医师计划应该支持持续的正念训练，以促进积极的文化转变。结论为外科培训生设计的改良正念课程是可行的、可取的，能减少焦虑，提高手术信心。

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Mindfulness in Surgical Training (MiST): A Modified Mindfulness Curriculum for Surgical Residents

OBJECTIVES

Residents experience numerous work-related and personal stressors that make it difficult to focus in the operating room, negatively impacting learning and surgical performance. Mindfulness-based cognitive therapy decreases anxiety and improves memory and learning. This study aimed to create a feasible and desirable modified mindfulness curriculum for surgical residents.

DESIGN

This was a prospective cohort study using multiple methods design to assess a 12-week modified mindfulness curriculum tailored to busy surgical trainees involving a 30 min group session weekly and 15 minutes home practice daily. The main outcomes were program feasibility and desirability. Focus groups explored how mindfulness techniques were used in the operating room. Secondary outcomes were measured in a pre- and post- intervention design assessing surgical performance, anxiety, confidence and burnout using validated assessment scales. Outcome measures were collected at baseline, immediately following the course and at 3 months postintervention.

SETTING

Academic obstetrics and gynecology residency program.

PARTICIPANTS

Obstetrics and gynecology residents in postgraduate years 2-5 at the University of Toronto were invited to participate in Mindfulness in Surgical Training.

RESULTS

Twelve (20%) out of 61 eligible residents enrolled in the program and 8 (67%) completed the course. There was a statistically significant decrease in anxiety (p < 0.001) and increase in surgical confidence (p = 0.007) following the mindfulness curriculum using validated survey tools. There was no change in burnout or surgical performance evaluations. Thematic analysis identified that mindfulness tools were beneficial and regularly utilized by participants in the operating room with sustained use 3 months post intervention. The biggest barrier to participation in the mindfulness curriculum was time. Participants felt the residency program should support ongoing mindfulness training to promote a positive culture shift.

CONCLUSIONS

A modified mindfulness curriculum designed for surgical trainees is feasible, desirable, reduces anxiety and increases surgical confidence.

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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.