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“我受够了!”:培训实习生识别和帮助苦苦挣扎的同事。

"I Cannot Take This Any More!": Preparing Interns to Identify and Help a Struggling Colleague.

机构信息

Department of Medicine, Division of General Internal Medicine and Clinical Innovation, NYU School of Medicine, 550 First Avenue, New York, NY, 10016, USA.

Department of Surgery, NYU School of Medicine, New York, NY, USA.

出版信息

J Gen Intern Med. 2019 May;34(5):773-777. doi: 10.1007/s11606-019-04886-y.

Abstract

BACKGROUND

Few programs train residents in recognizing and responding to distressed colleagues at risk for suicide.

AIM

To assess interns' ability to identify a struggling colleague, describe resources, and recognize that physicians can and should help colleagues in trouble.

SETTING

Residency programs at an academic medical center.

PARTICIPANTS

One hundred forty-five interns.

PROGRAM DESIGN

An OSCE case was designed to give interns practice and feedback on their skills in recognizing a colleague in distress and recommending the appropriate course of action. Embedded in a patient "sign-out" case, standardized health professionals (SHP) portrayed a resident with depressed mood and an underlying drinking problem. The SHP assessed intern skills in assessing symptoms and directing the resident to seek help.

PROGRAM EVALUATION

Interns appreciated the opportunity to practice addressing this situation. Debriefing the case led to productive conversations between faculty and residents on available resources. Interns' skills require further development: while 60% of interns asked about their colleague's emotional state, only one-third screened for depression and just under half explored suicidal ideation. Only 32% directed the colleague to specific resources for his depression (higher among those that checked his emotional state, 54%, or screened for depression, 80%).

DISCUSSION

This OSCE case identified varying intern skill levels for identifying and assessing a struggling colleague while also providing experiential learning and supporting a culture of addressing peer wellness.

摘要

背景

很少有项目培训住院医师识别和应对有自杀风险的同事。

目的

评估实习医生识别陷入困境的同事、描述资源的能力,并认识到医生可以而且应该帮助有困难的同事。

地点

学术医疗中心的住院医师培训计划。

参与者

145 名实习医生。

方案设计

设计了一项 OSCE 案例,让实习医生有机会练习和反馈他们识别有困扰的同事并推荐适当行动方案的技能。在一个患者“交班”案例中嵌入标准化健康专业人员(SHP),描绘了一位情绪低落且有潜在饮酒问题的住院医师。SHP 评估实习医生评估症状并指导住院医师寻求帮助的技能。

方案评估

实习医生很欣赏有机会练习处理这种情况。对案例进行讨论导致了教员和住院医师之间关于可用资源的富有成效的对话。实习医生的技能需要进一步发展:虽然 60%的实习医生询问了同事的情绪状态,但只有三分之一的人筛查了抑郁,不到一半的人探索了自杀意念。只有 32%的人将同事引导至特定的抑郁资源(询问其情绪状态的人中有 54%,筛查抑郁的人中有 80%)。

讨论

这个 OSCE 案例确定了实习医生在识别和评估陷入困境的同事方面的不同技能水平,同时提供了体验式学习,并支持解决同侪健康问题的文化。

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A Physician's Suffering-Facing Depression as a Trainee.一名实习医生面对抑郁症的痛苦
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