Fischer Jason, Alpert Aviva, Rao Priyanka
Pediatric Emergency Medicine Fellow, Division of Emergency Medicine, Children's Hospital of Philadelphia.
General Pediatrician, Children's Community Pediatrics Allegheny, University of Pittsburgh Medical Center.
MedEdPORTAL. 2019 Oct 25;15:10848. doi: 10.15766/mep_2374-8265.10848.
Promoting resilience is key during intern year as residents transition to becoming clinical providers. Residents consistently demonstrate a decline in empathy and an increase in burnout throughout training. Interventions involving mindfulness, stress management, and small-group discussions can reduce burnout. We created a curriculum to normalize the intern experience and provide debriefing opportunities to further improve resilience and decrease burnout.
Thirty-two interns met monthly, one-on-one, with a pediatric chief resident to discuss personal, professional, and emotional well-being and complete just-in-time resilience exercises. After 6 and 12 months, we conducted follow-up surveys containing 5-point Likert questions and open-ended questions to determine interns' perceptions of the initiative.
We obtained response rates of 44% (14 interns) and 38% (12 interns) for the 6- and 12-month surveys, respectively. Interns found the sessions helpful for normalizing the intern experience (6 months: 4.6 ± 0.7, 12 months: 4.8 ± 0.5), stress management (6 months: 4.0 ± 1.0, 12 months: 4.3 ± 0.7), and feeling connected to program leadership (6 months: 4.6 ± 0.9, 12 months: 5.0 ± 0.0). Thematic analysis identified normalizing the intern experience, ability to express concerns, and mentorship as benefits.
Normalization of the intern experience and targeted wellness and resilience exercises can have a positive impact on interns' satisfaction with program support for their well-being. Through a time-limited intervention, chief residents can be utilized in a mentorship role that is well received by interns and rewarding for the chief residents.
在实习医生向临床医生过渡的实习年期间，提升适应力是关键。在整个培训过程中，实习医生的同理心持续下降，职业倦怠感不断增加。涉及正念、压力管理和小组讨论的干预措施可以减少职业倦怠。我们创建了一门课程，以使实习医生的经历常态化，并提供汇报交流机会，以进一步提高适应力并减少职业倦怠。
32名实习医生每月与一名儿科总住院医师进行一对一交流，讨论个人、职业和情绪健康状况，并完成即时适应力练习。在6个月和12个月后，我们进行了后续调查，其中包含5级李克特量表问题和开放式问题，以确定实习医生对该项目的看法。
6个月和12个月调查的回复率分别为44%（14名实习医生）和38%（12名实习医生）。实习医生发现这些课程有助于使实习经历常态化（6个月：4.6±0.7，12个月：4.8±0.5）、压力管理（6个月：4.0±1.0，12个月： 4.3±0.7）以及感觉与项目负责人有联系（6个月：4.6±0.9，12个月：5.0±0.0）。主题分析确定使实习经历常态化、表达担忧的能力和指导是有益之处。
实习经历的常态化以及有针对性的健康和适应力练习可以对实习医生对项目对其幸福感支持的满意度产生积极影响。通过限时干预，可以让总住院医师发挥指导作用，这种作用受到实习医生的欢迎，对总住院医师也有回报。
