高度人文主义外科医生的态度和习惯：一项单机构、混合方法研究。

Attitudes and Habits of Highly Humanistic Surgeons: A Single-Institution, Mixed-Methods Study.

机构信息

R.A. Swendiman is a general surgery resident, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. C.L. Marcaccio is a vascular surgery resident, Beth Israel Deaconess Medical Center, Boston, Massachusetts. J. Han is a cardiothoracic surgery resident, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. D.I. Hoffman is a medical student, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. T.M. Weiner is a pediatric surgeon, New Hanover Regional Medical Center, Wilmington, North Carolina, and adjunct professor of surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina. M.L. Nance is Josephine J. and John M. Templeton Jr. Endowed Chair in Pediatric Trauma, Children's Hospital of Philadelphia, and professor of pediatric surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. C.M. Chou is associate professor of clinical medicine, Department of Medicine, Division of General Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

出版信息

Acad Med. 2019 Jul;94(7):1027-1032. doi: 10.1097/ACM.0000000000002690.

DOI:10.1097/ACM.0000000000002690

PMID:30844930

Abstract

PURPOSE

Humanism in medicine is associated with increased patient satisfaction, trust of patients in their doctors, and better outcomes. The authors sought to identify attitudes, habits, and other factors that sustain humanism in academic surgical faculty, and compare these with attributes determined from a previous study of internal medicine faculty.

METHOD

A mixed-methods study design at University of Pennsylvania Health System was employed from 2016 to 2018 using a survey instrument and semistructured interviews. Surgical residents nominated faculty who exemplified humanism. In-depth interviews were then conducted with surgeons receiving the most nominations. The interviews were transcribed, and common themes were identified using the grounded theory method. These were compared with findings from a previous internal medicine study.

RESULTS

Ten faculty described three strongly shared attitudes: humility, responsibility, and a desire to live up to a high standard of professional behavior. Five habits were found important to sustaining these attitudes and their practice: self-reflection, finding deep connections with patients, maintaining personal and professional relationships, "having fun" at work, and paying it forward to surgical trainees. Surgeons also cited the importance of past role models in developing humanistic attitudes and sustaining practice. Responses were compared with previously documented attitudes and habits of humanistic internal medicine faculty at the institution.

CONCLUSIONS

This study identified recurring attitudes and habits that characterize humanistic behaviors in a cohort of academic surgeons. Learning from these exemplary humanistic surgeons may inform the development of future educational programs for residents and faculty in sustaining humanism.

摘要

目的

医学人文主义与提高患者满意度、患者对医生的信任以及改善治疗结果相关。作者旨在确定维持学术外科教员人文主义的态度、习惯和其他因素，并将这些因素与先前对内科教员的研究中确定的属性进行比较。

方法

宾夕法尼亚大学卫生系统在 2016 年至 2018 年期间采用混合方法研究设计，使用调查工具和半结构化访谈。外科住院医师提名体现人文主义的教员。然后对获得最多提名的外科医生进行深入访谈。对访谈进行转录，并使用扎根理论方法识别共同主题。将这些主题与先前的内科研究结果进行比较。

结果

十位教员描述了三个强烈共有的态度：谦逊、责任感和努力达到高标准的专业行为。发现五个习惯对维持这些态度和实践很重要：自我反思、与患者建立深厚的联系、保持个人和职业关系、“工作中获得乐趣”以及将其传承给外科学员。外科医生还提到过去的榜样在培养人文主义态度和维持实践方面的重要性。将这些反应与该机构先前记录的人文主义内科教员的态度和习惯进行了比较。