Aggarwal Rashi, Deutsch Jill K, Medina Jose, Kothari Neil
Associate Professor, Department of Psychiatry, Rutgers New Jersey Medical School.
Chief Medical Resident, Department of Medicine, Rutgers New Jersey Medical School.
MedEdPORTAL. 2017 Nov 6;13:10651. doi: 10.15766/mep_2374-8265.10651.
Despite the national focus on trainee burnout, effective wellness programs that can easily be incorporated into training curriculums are lacking. Strategies such as mindfulness and positive psychology, linked with deep breathing, have been shown to increase resiliency. We hypothesized that education about the neuroscience literature, coupled with teaching about well-being using short, easy-to-practice evidence-based exercises, would increase acceptance of this curriculum among residents and that providing protected time to practice these exercises would help trainees incorporate them into their daily lives.
Residents were asked to attend a 60-minute didactic featuring both the concepts and science behind well-being. Residents then attended 15-minute booster sessions during protected didactic time each week for a 12-week curriculum. The booster sessions were peer-led by wellness champions. Additionally, there were monthly competitions using free phone apps to promote physical fitness through steps and flights challenges.
The 12-week curriculum was offered to 272 residents across five subspecialties of internal medicine, general surgery, anesthesiology, psychiatry, and physical medicine and rehabilitation. A total of 188 residents (69%) participated in the initial didactic component. The curriculum was positively received, with four of the five residency programs participating in weekly sessions. Residents in four participating departments then chose to continue the weekly sessions on a voluntary basis after the initial 12-week curriculum.
It is feasible to implement a low-cost, peer-led wellness curriculum to educate residents and foster an environment during residency training where mindfulness, optimism, gratitude, and social connectedness are the norm.
尽管全国都在关注实习医生的职业倦怠问题,但缺乏能够轻松融入培训课程的有效健康计划。诸如正念和积极心理学等与深呼吸相关的策略已被证明可以提高恢复力。我们假设,关于神经科学文献的教育,再加上使用简短、易于实践的循证练习来教授幸福感,将提高住院医师对该课程的接受度,并且提供专门时间来练习这些练习将有助于实习医生将其融入日常生活。
要求住院医师参加一个60分钟的教学课程,内容包括幸福感背后的概念和科学。然后,住院医师在每周专门的教学时间参加15分钟的强化课程,为期12周。强化课程由健康倡导者进行同伴指导。此外,每月还会使用免费手机应用程序举办竞赛,通过步数和楼层挑战来促进身体健康。
为来自内科、普通外科、麻醉学、精神病学以及物理医学与康复学五个亚专业的272名住院医师提供了为期12周的课程。共有188名住院医师(69%)参加了初始教学部分。该课程受到了积极的反馈,五个住院医师培训项目中有四个参与了每周的课程。在最初的12周课程结束后,四个参与部门的住院医师随后自愿选择继续参加每周的课程。
实施一个低成本、由同伴指导的健康课程以教育住院医师,并在住院医师培训期间营造一种以正念、乐观、感恩和社会联系为常态的环境是可行的。