Carl R. Darnall Army Medical Center, Department of Emergency Medicine, Fort Hood, Texas.
Loma Linda University Medical Center, Department of Emergency Medicine, Loma Linda, California.
West J Emerg Med. 2018 Mar;19(2):337-341. doi: 10.5811/westjem.2017.12.36244. Epub 2018 Feb 26.
Physicians are at much higher risk for burnout, depression, and suicide than their non-medical peers. One of the working groups from the May 2017 Resident Wellness Consensus Summit (RWCS) addressed this issue through the development of a longitudinal residency curriculum to address resident wellness and burnout.
A 30-person (27 residents, three attending physicians) Wellness Curriculum Development workgroup developed the curriculum in two phases. In the first phase, the workgroup worked asynchronously in the Wellness Think Tank - an online resident community - conducting a literature review to identify 10 core topics. In the second phase, the workgroup expanded to include residents outside the Wellness Think Tank at the live RWCS event to identify gaps in the curriculum. This resulted in an additional seven core topics.
Seventeen foundational topics served as the framework for the longitudinal resident wellness curriculum. The curriculum includes a two-module introduction to wellness; a seven-module "Self-Care Series" focusing on the appropriate structure of wellness activities and everyday necessities that promote physician wellness; a two-module section on physician suicide and self-help; a four-module "Clinical Care Series" focusing on delivering bad news, navigating difficult patient encounters, dealing with difficult consultants and staff members, and debriefing traumatic events in the emergency department; wellness in the workplace; and dealing with medical errors and shame.
The resident wellness curriculum, derived from an evidence-based approach and input of residents from the Wellness Think Tank and the RWCS event, provides a guiding framework for residency programs in emergency medicine and potentially other specialties to improve physician wellness and promote a culture of wellness.
医生比非医疗同行更容易出现倦怠、抑郁和自杀的风险。2017 年 5 月居民健康共识峰会（RWCS）的一个工作组通过制定一项针对居民健康和倦怠的纵向居住课程来解决这个问题。
一个由 30 人（27 名住院医师和 3 名主治医生）组成的健康课程开发工作组在两个阶段开发了课程。在第一阶段，工作组在 Wellness Think Tank（一个在线居民社区）中异步工作，进行文献回顾，以确定 10 个核心主题。在第二阶段，工作组扩大到包括 RWCS 现场的 Wellness Think Tank 以外的居民，以确定课程中的差距。这导致了另外七个核心主题。
十七个基础主题作为纵向居民健康课程的框架。该课程包括两部分的健康入门模块；一个七部分的“自我保健系列”，侧重于适当的健康活动结构和日常必需品，以促进医生的健康；一个关于医生自杀和自助的两个模块部分；一个四部分的“临床护理系列”，重点是传递坏消息、处理困难的患者遭遇、处理困难的顾问和工作人员，以及在急诊室创伤事件的汇报；工作场所的健康；以及处理医疗错误和耻辱。
该居民健康课程源自循证方法，并吸收了来自 Wellness Think Tank 和 RWCS 活动的住院医师的意见，为急诊医学和其他潜在专业的住院医师课程提供了一个指导框架，以改善医生的健康，并促进健康文化。
