Cohen-Katz Joanne, Sternlieb Jeffrey L, Hansen Susan E, Dostal Julie A
J Grad Med Educ. 2016 Dec;8(5):692-698. doi: 10.4300/JGME-D-15-00548.1.
Burnout continues to erode the physician workforce, and there are few effective intervention studies to guide educators.
We explored residents' experience in a model environment emphasizing resident wellness, safety, and interpersonal skills.
As 1 of 14 participants in the national Preparing the Personal Physician for Practice (P) project, the family medicine residency at Lehigh Valley Health Network implemented a series of curricular changes designed to transform the culture of education. This mixed-methods case study utilizes the results from 3 quantitative self-report instruments for well-being, along with content analysis of transcripts from 20 focus groups and 33 resident advising sessions to describe experiences of the residents enrolled between July 2007 and June 2012.
In the intervention, we found no statistically significant quantitative differences in the well-being of residents compared with the family medicine faculty and staff. Deductive (a priori and template) analysis and inductive thematic analysis of the residents' articulations of their experiences revealed 6 recurrent themes: naming/articulation of emotions, relationships, attitudes about self-care, self-reflection, delivery of learning experiences, and availability of resources.
Quantitative measures of well-being did not capture the experiential value of the curricular innovations implemented by the residency program, while qualitative analysis highlighted themes important to residents. While not all residents in the intervention expressed support for the changes, repeated references to the nurturing educational environment indicate recognition of, and favorable responses to, the creation of an emotionally intelligent learning community.
职业倦怠持续侵蚀着医师队伍，而几乎没有有效的干预研究可为教育工作者提供指导。
我们在一个强调住院医师健康、安全和人际技能的示范环境中探索住院医师的经历。
作为全国“为临床实践培养个体医师（P）项目”的14个参与者之一，里海谷医疗网络的家庭医学住院医师培训项目实施了一系列课程改革，旨在转变教育文化。这项混合方法的案例研究利用了3种关于幸福感的定量自我报告工具的结果，以及对20个焦点小组和33次住院医师咨询会议的记录进行的内容分析，以描述2007年7月至2012年6月期间入学的住院医师的经历。
在干预过程中，我们发现与家庭医学教职员工相比，住院医师的幸福感在统计学上没有显著的定量差异。对住院医师对其经历的阐述进行的演绎（先验和模板）分析和归纳主题分析揭示了6个反复出现的主题：情绪的命名/表达、人际关系、自我护理态度、自我反思、学习经历的提供以及资源的可用性。
幸福感的定量测量没有体现住院医师培训项目实施的课程创新的体验价值，而定性分析突出了对住院医师重要的主题。虽然并非干预中的所有住院医师都对这些变化表示支持，但对培养性教育环境的反复提及表明对创建一个具有情商的学习社区的认可和积极回应。
