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干预措施预防和减少本科和研究生医学教育受训者的倦怠:系统评价。

Interventions to Prevent and Reduce Burnout Among Undergraduate and Graduate Medical Education Trainees: a Systematic Review.

机构信息

Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Case Western Reserve University School of Medicine, Cleveland, OH, USA.

出版信息

Acad Psychiatry. 2019 Aug;43(4):386-395. doi: 10.1007/s40596-019-01023-z. Epub 2019 Feb 1.

Abstract

OBJECTIVE

The authors conducted a systematic review of the published literature to identify interventions to prevent and/or reduce burnout among medical students and residents.

METHODS

The authors searched 10 databases (from the start of each through September 21, 2016) using keywords related to burnout, medical education, and prevention. Teams of two authors independently reviewed the search results to select peer-reviewed, English language articles describing educational interventions to prevent and/or reduce burnout among medical students and/or residents that were evaluated using validated burnout measures. They assessed study quality using the Medical Education Research Study Quality Instrument and the Cochrane Risk of Bias Tool.

RESULTS

Fourteen studies met inclusion criteria and all used the Maslach Burnout Inventory as at least one measure of burnout. Four were single group pre-post studies, 6 non-randomized two-group studies, and 4 randomized controlled trials. None of the studies were designed specifically to target burnout prevention. In 12 studies, residents were the targeted learners. Six of the 14 studies reported statistically significant changes in burnout scores: 5 reported improvement and 1 reported worsening of burnout. Of the 5 studies that reported statistically significant benefit, 1 studied a complementary and alternative medicine elective, 1 studied the Respiratory One Meditation method, and 3 studied duty hour changes.

CONCLUSIONS

This review highlights the need for rigorously designed studies in burnout prevention and reduction among residents and especially medical students.

摘要

目的

作者对已发表的文献进行了系统评价,以确定预防和/或减少医学生和住院医师倦怠的干预措施。

方法

作者使用与倦怠、医学教育和预防相关的关键词,在 10 个数据库中进行了搜索(从每个数据库的开始到 2016 年 9 月 21 日)。两名作者团队独立审查搜索结果,选择同行评议的、以英语撰写的描述预防和/或减少医学生和/或住院医师倦怠的教育干预措施的文章,这些干预措施使用经过验证的倦怠测量方法进行评估。他们使用医学教育研究研究质量工具和 Cochrane 偏倚风险工具评估研究质量。

结果

14 项研究符合纳入标准,所有研究均使用 Maslach 倦怠量表作为至少一种倦怠测量方法。其中 4 项为单组前后研究,6 项为非随机两群组研究,4 项为随机对照试验。没有一项研究是专门针对预防倦怠而设计的。在 12 项研究中,住院医师是目标学习者。14 项研究中有 6 项报告了倦怠评分的统计学显著变化:5 项报告了倦怠的改善,1 项报告了倦怠的恶化。在报告有统计学意义益处的 5 项研究中,1 项研究了补充和替代医学选修课程,1 项研究了呼吸一冥想方法,3 项研究了工作时间变化。

结论

本综述强调了需要针对住院医师和医学生倦怠预防和减少进行严格设计的研究。

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