Ewen Alana M, Gardiner Paula M, Palma Sandra, Whitley Kathryn, Schneider Jeffrey I
Ms. Ewen: Data Analyst, Office of Graduate Medical Education, Boston Medical Center, Boston, MA. Dr. Gardiner: Associate Professor in the Department of Family Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA. Ms. Palma: GME Housestaff Coordinator in the Office of Graduate Medical Education, Boston Medical Center, Boston, MA. Ms. Whitley: Residency and Fellowship Coordinator, Department of Family Medicine, Boston Medical Center, Boston, MA. Dr. Schneider: Designated Institutional Official for ACGME, the Chair of the Graduate Medical Education Committee, the Dean for Graduate Medical Education at Boston Medical Center and the Boston University School of Medicine, and Assistant Professor in the Department of Emergency Medicine, Boston, MA.
J Contin Educ Health Prof. 2018 Summer;38(3):165-170. doi: 10.1097/CEH.0000000000000209.
Burnout and stress in medical settings have been associated with despondent staff and decreased productivity. Although Program Coordinators (PCs) play an integral role in residency training programs, there exist few, if any, interventions aimed at addressing their burnout.
A longitudinal study design was used to evaluate data from residency/fellowship training PCs who participated in a wellness retreat held at a single institution in August 2016. Subjects completed anonymous, pre- and post-retreat questionnaires in addition to a 3-month follow-up questionnaire, which included questions used to assess aspects of job demand, resiliency, and well-being. The seven-item Physician Well-Being Index and a logistic regression model were used to assess well-being. Mean values and SDs were reported to examine changes in mental health scores and participants' job satisfaction over the course of the intervention.
Nineteen of the 45 (43%) invited residency/fellowship training PCs completed data collection. Coordinators ranged in age from 25 to 64 years; all were female. Well-being, sleep, resiliency, and employee satisfaction scores improved over the assessment period. Well-being scores initially decreased by 0.37 at the postassessment, but increased at follow-up (mean: 2.0; SD 1.7). Stress scores increased from baseline to post, but decreased from baseline to follow-up: 0.2 and -0.2, respectively.
Residency PCs experienced improvements in mental quality of life, resiliency, stress, and sleep scores on attending the wellness program. Attention to such findings may have important implications, as we address the burnout crisis in the medical education community.
医疗环境中的职业倦怠和压力与员工情绪低落及生产力下降有关。尽管项目协调员在住院医师培训项目中发挥着不可或缺的作用，但针对解决他们职业倦怠问题的干预措施却寥寥无几。
采用纵向研究设计，对参加2016年8月在单一机构举办的健康休养活动的住院医师/专科医师培训项目协调员的数据进行评估。除了一份为期3个月的随访问卷外，受试者还完成了匿名的休养前和休养后问卷，其中包括用于评估工作需求、适应能力和幸福感等方面的问题。使用七项医师幸福感指数和逻辑回归模型来评估幸福感。报告均值和标准差以检查干预过程中心理健康得分和参与者工作满意度的变化。
45名受邀的住院医师/专科医师培训项目协调员中有19名（43%）完成了数据收集。协调员年龄在25岁至64岁之间；均为女性。在评估期间，幸福感、睡眠、适应能力和员工满意度得分均有所提高。幸福感得分在评估后最初下降了0.37，但在随访时有所上升（均值：2.0；标准差1.7）。压力得分从基线到评估后有所增加，但从基线到随访时有所下降：分别为0.2和 -0.2。
住院医师项目协调员参加健康项目后，心理生活质量、适应能力、压力和睡眠得分均有所改善。关注这些发现可能具有重要意义，因为我们正在应对医学教育界的职业倦怠危机。
