在住院医师研究生医学教育中对抗医师职业倦怠和促进健康。

HCA healthcare journal of medicine Pub Date : 2025-04-01 eCollection Date: 2025-01-01 DOI:10.36518/2689-0216.1883
Abdulaziz Mheir, Zohare Khan, Franklin Hernandez, Alaa Mohamed, Chandan Mitra
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摘要

背景:在过去的二十年中,研究生医学教育(GME)领域发生了文化转变,重点关注一个重要方面:医生职业倦怠。倦怠被定义为情绪衰竭、人格解体和缺乏个人成就感的结合。随着对医生职业倦怠意识的提高,各种健康倡议已开始在培训项目中实施,其结果已被衡量为降低职业倦怠率的有效性。由于在GME项目中出现的倦怠率不断上升,我们在论坛上与所有住院医师讨论了评估我们内科(IM)住院医师在这个问题上的主动性,并得出了几个可以帮助减少倦怠的改进领域。本项目旨在在GME项目中实施新的健康计划后,使用Maslach职业倦怠量表(MBI)自我评估工具测量IM住院医师的职业倦怠率。方法:我们采用涉及多个利益相关者的多因素方法,重点关注IM住院医师在举办的论坛上概述的各个方面,包括教育、财务、身体、心理和社会健康,积极解决医生职业倦怠现象。一旦确定了需要改进的领域,就实施了改进每个领域的步骤。MBI调查1是衡量干预后职业倦怠率的主要评估工具。收集调查数据,对研究生1、2、3年住院医师的职业倦怠率进行平均。结果:干预后PGY1居民人格解体显著降低(P = 0.0224)。干预后PGY3居民情绪衰竭(P = 0.0014)和人格解体(P = 0.0345)显著降低。PGY2的居民没有明显的变化。结论:根据初步数据显示,在各方面的干预措施改善了结果,我们的目标是发展我们的健康倡议,使用数据来指导我们减少倦怠的努力,提高我们居民的整体幸福感。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Combating Physician Burnout and Fostering Wellness in Graduate Medical Education for Resident Physicians.

Background: Over the last 2 decades, there has been a cultural shift in the graduate medical education (GME) space, focusing on an important facet: physician burnout. Burnout is defined as a combination of emotional exhaustion, depersonalization, and a lack of personal accomplishment. With increasing awareness of physician burnout, various wellness initiatives have begun to be implemented throughout training programs, and their results have been measured for effectiveness in reducing burnout rates. Due to the increasing rates of burnout emerging throughout GME programs, an initiative to evaluate our internal medicine (IM) residency on this matter was discussed with all residents at forums and yielded several areas where improvement could help reduce burnout. This project aimed to measure the burnout rates among our IM resident physicians using the Maslach Burnout Inventory (MBI) self-assessment tool after implementing new wellness initiatives in the GME program.

Methods: We sought to actively address the physician burnout phenomenon using a multi-factorial approach that involved several stakeholders and focused on aspects our IM residents outlined during held forums, which included education, financial, physical, mental, and social wellness. Once areas of improvement were identified, steps to improve each field were implemented. The MBI Survey 1 was the primary assessment tool used to measure the rates of burnout after interventions. Survey data were collected, and burnout rates were averaged across postgraduate year (PGY) 1, 2, and 3 residents.

Results: Depersonalization was significantly reduced (P = .0224) for PGY1 residents following intervention. Emotional exhaustion (P = .0014) and depersonalization (P = .0345) were significantly lower for PGY3 residents following interventions. There were no significant changes for PGY2 residents.

Conclusion: Based on preliminary data showing improved outcomes following interventions in various aspects, we aim to grow our wellness initiative using data to guide our efforts to reduce burnout and improve the overall well-being of our residents.

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