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住院医师和教员对预防住院医师职业倦怠的看法:一项焦点小组研究。

Resident and Faculty Perspectives on Prevention of Resident Burnout: A Focus Group Study.

作者信息

Ironside Kristen, Becker Davida, Chen Isabel, Daniyan Adegbemisola, Kian Ary, Saheba Neeta, Hollander Rachel

机构信息

Center for Medical Education, Kaiser Permanente, Los Angeles, CA.

Graduate Medical Education & Development, Kaiser Permanente, Pasadena, CA.

出版信息

Perm J. 2019;23. doi: 10.7812/TPP/18-185. Epub 2019 Jun 24.

Abstract

CONTEXT

The high prevalence and negative implications of resident physicians' burnout is well documented, yet few effective interventions have been identified.

OBJECTIVE

To document resident and faculty perspectives on resident burnout, including perceived contributing factors and their recommended strategies for attention and prevention.

DESIGN

We conducted 14 focus groups with core faculty and residents in 5 specialties at a large integrated health care system in Southern California. Training programs sampled included family medicine, internal medicine, obstetrics and gynecology, pediatrics, and psychiatry. Discussions were recorded, transcribed, and analyzed using a matrix-based approach to identify common themes.

MAIN OUTCOME MEASURES

Resident and faculty perspectives regarding causes of burnout, preventive factors, and potential intervention strategies.

RESULTS

Five themes captured the range of factors participants identified as contributing or protective factors for resident burnout: 1) having or lacking a sense of meaning at work; 2) fatigue and exhaustion; 3) cultural norms in medicine; 4) the steep learning curve from medical school to residency; and 5) social relationships at and outside work. Recommended intervention strategies targeted individuals, residents' social networks, and the learning and work environment.

CONCLUSION

We engaged residents and core faculty across specialties in the identification of factors contributing to burnout and possible targets for interventions. Our results highlight potential focus areas for future burnout interventions and point to the importance of interventions targeted at the social environments in which residents' work and learn.

摘要

背景

住院医师职业倦怠的高发生率及其负面影响已有充分记录,但尚未发现有效的干预措施。

目的

记录住院医师和教员对住院医师职业倦怠的看法,包括感知到的促成因素以及他们推荐的关注和预防策略。

设计

我们在南加州一个大型综合医疗系统中,对5个专业的核心教员和住院医师进行了14次焦点小组讨论。抽样的培训项目包括家庭医学、内科、妇产科、儿科和精神病学。讨论内容进行了录音、转录,并采用基于矩阵的方法进行分析,以确定共同主题。

主要观察指标

住院医师和教员对职业倦怠原因、预防因素和潜在干预策略的看法。

结果

五个主题涵盖了参与者确定的导致住院医师职业倦怠的促成因素或保护因素的范围:1)工作中有无意义感;2)疲劳和疲惫;3)医学文化规范;4)从医学院到住院医师培训的陡峭学习曲线;5)工作内外的社会关系。推荐的干预策略针对个人、住院医师的社交网络以及学习和工作环境。

结论

我们让各专业的住院医师和核心教员参与确定导致职业倦怠的因素以及可能的干预目标。我们的结果突出了未来职业倦怠干预的潜在重点领域,并指出针对住院医师工作和学习的社会环境进行干预的重要性。

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