Acad Med. 2011 Jul;86(7):801-3. doi: 10.1097/ACM.0b013e31821da481.
Studies have found a high prevalence of psychological distress among medical students both in the United States and abroad. Distress among medical students has serious professional ramifications, including damaging effects on empathy, ethical conduct, and professionalism, as well as personal consequences such as substance abuse, broken relationships, and suicidal ideation. Given the effect of physician distress on quality of care, self-care (including personal appraisal of well-being, wellness promotion, and recognition of when help is needed) should be recognized as a core competency for physicians. In this issue of Academic Medicine, investigators at the Northwestern University Feinberg School of Medicine explore the benefits of teaching students to employ a cognitive behavioral approach to improving self-care. Beyond its demonstrated short-term efficacy, the approach they propose also has potential to help students develop the skills necessary to assess and promote resilience throughout their careers. Medical schools' responsibility to promote student wellness, however, goes beyond teaching students self-care skills and includes establishing an appropriate organizational culture and learning environment to promote student health. Achieving competency in self-care is a shared responsibility of the individual physician/resident/medical student and the organizational environment in which he or she functions.
研究发现，美国和其他国家的医学生都普遍存在心理困扰。医学生的困扰会带来严重的职业后果，包括对同理心、道德行为和专业精神产生破坏性影响，以及物质滥用、人际关系破裂和自杀意念等个人后果。鉴于医生的困扰对医疗质量的影响，自我保健（包括对幸福感的个人评估、促进健康和认识何时需要帮助）应被视为医生的核心能力。在本期《学术医学》中，西北大学范伯格医学院的研究人员探讨了教授学生采用认知行为方法来改善自我保健的好处。除了已证明的短期效果外，他们提出的方法还有可能帮助学生发展评估和促进整个职业生涯中韧性所需的技能。然而，医学院促进学生健康的责任不仅在于教授学生自我保健技能，还包括建立适当的组织文化和学习环境。实现自我保健能力是个体医生/住院医师/医学生和他或她所在的组织环境的共同责任。
