Liu Chun-Hao, Tang Woung-Ru, Weng Wei-Hung, Lin Yu-Hsuan, Chen Ching-Yen
School of Medicine, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Taoyuan, Taiwan.
Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, NO.5, Fusing Street, Kwei-Shan, Taoyuan, Taiwan.
BMC Med Educ. 2016 Jan 12;16:10. doi: 10.1186/s12909-016-0534-3.
Internship, the transition period from medical student to junior doctor, is highly stressful for interns in the West; however, little is known about the experience of interns in coping with stress in Taiwan. This study aimed to develop a model for coping with stress among Taiwanese interns and to examine the relationship between stress and learning outcomes.
For this qualitative study, we used grounded theory methodology with theoretical sampling. We collected data through in-depth interviews and participant observations. We employed the constant comparative method to analyse the data until data saturation was achieved.
The study population was 124 medical interns in a teaching hospital in northern Taiwan; 21 interns (12 males) participated. Data analysis revealed that the interns encountered stressors (such as sense of responsibility, coping with uncertainty, and interpersonal relationships) resulting from their role transition from observer to practitioner. The participants used self-directed learning and avoidance as strategies to deal with their stress.
A self-directed learning strategy can be beneficial for an intern's motivation to learn as well as for patient welfare. However, avoiding stressors can result in less motivation to learn and hinder the quality of care. Understanding how interns experience and cope with stress and its related outcomes can help medical educators and policy makers improve the quality of medical education by encouraging interns' self-directed learning strategy and discouraging the avoidance of stressors.
实习阶段是医学生向初级医生的过渡时期，在西方，实习医生面临着巨大的压力；然而，对于台湾实习医生应对压力的经历却知之甚少。本研究旨在构建一个台湾实习医生应对压力的模型，并探讨压力与学习成果之间的关系。
对于这项定性研究，我们采用扎根理论方法和理论抽样。我们通过深入访谈和参与观察收集数据。我们采用持续比较法分析数据，直至达到数据饱和。
研究对象为台湾北部一家教学医院的124名医学生；21名实习生（12名男性）参与其中。数据分析显示，实习生在从观察者向从业者的角色转变过程中遇到了压力源（如责任感、应对不确定性和人际关系）。参与者采用自主学习和回避作为应对压力的策略。
自主学习策略有助于提高实习生的学习动力以及患者的福利。然而，回避压力源可能会导致学习动力下降，并阻碍护理质量。了解实习生如何体验和应对压力及其相关结果，有助于医学教育工作者和政策制定者通过鼓励实习生的自主学习策略和抑制回避压力源的行为来提高医学教育质量。
