Dotters-Katz Sarah K, Chuang Alice, Weil Amy, Howell Jennifer O
Department of Obstetrics and Gynecology, Duke University, Durham, USA.
Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, USA.
J Educ Health Promot. 2018 Jan 10;7:2. doi: 10.4103/jehp.jehp_45_17. eCollection 2018.
Humanism is a central tenant of professionalism, a required competency for all residency programs. Yet, few residencies have formal curriculum for teaching this critical aspect of medicine. Instead, professionalism and humanism are often taught informally through role-modeling. With increased burnout, faculty professionalism may suffer and may compromise resident role-modeling. The objective of this study was to design a pilot curriculum to foster humanism in among residents and assess its ability to do so.
Two-phase exploratory sequential mixed methods study. Phase 1: a qualitative analysis of residents' narratives regarding challenges to humanistic behavior, and identified themes of compassion, fatigue, communication challenges, and work-life balance. Themes used as needs assessment to build curriculum. Phase 2: three sessions with themes taken from faculty development course. Participants and controls completed baseline and 60-day follow-up questionnaires assessing burnout, compassion, satisfaction, and ability to practice psychological medicine. Phase one included Obstetrics/Gynecology and internal medicine residents. Phase two included residents from the above programs, who attended at least 2/3 interactive sessions designed to address the themes identified above.
Twelve participants began and ten completed curriculum (83%). The curriculum met course objectives and was well-received (4.8/5). Burnout decreased (-3.1 vs. 2.5, = 0.048). A trend toward improved compassion (4.4 vs.-0.6, = 0.096) for participants compared to controls was noted.
A pilot humanism curriculum for residents was well-received. Participants showed decreased burnout and trended to improved compassion scores. Development and evaluation of an expanded curriculum would further explore feasibility and effectiveness of the intervention.
人文主义是专业精神的核心要素，是所有住院医师培训项目的一项必备能力。然而，很少有住院医师培训项目设有正式课程来教授医学这一关键方面。相反，专业精神和人文主义通常通过榜样示范进行非正式传授。随着职业倦怠的增加，教师的专业精神可能会受到影响，进而可能损害住院医师的榜样示范作用。本研究的目的是设计一个试点课程，以培养住院医师的人文主义精神并评估其实现这一目标的能力。
两阶段探索性序列混合方法研究。第一阶段：对住院医师关于人文行为挑战的叙述进行定性分析，确定了同情、疲劳、沟通挑战和工作与生活平衡等主题。这些主题用作需求评估以构建课程。第二阶段：举办三次课程，主题取自教师发展课程。参与者和对照组完成基线和60天随访问卷，评估职业倦怠、同情心、满意度以及实施心理医学的能力。第一阶段包括妇产科和内科住院医师。第二阶段包括上述项目的住院医师，他们参加了至少三分之二旨在解决上述确定主题的互动课程。
12名参与者开始课程，10名完成课程（83%）。该课程达到了课程目标且受到好评（4.8/5）。职业倦怠有所下降（-3.1对2.5，P = 0.048）。与对照组相比，参与者的同情心有改善趋势（4.4对-0.6，P = 0.096）。
为住院医师设计的试点人文主义课程受到好评。参与者的职业倦怠有所下降，同情心得分有改善趋势。扩展课程的开发和评估将进一步探索该干预措施的可行性和有效性。
