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监管住院医师中的“七月效应”:评估不断增加的内科住院医师 2 年级住院医师的情绪,以及定向撤退的影响。

The 'July Effect' in supervisory residents: assessing the emotions of rising internal medicine PGY2 residents and the impact of an orientation retreat.

机构信息

Internal Medicine Residency Program, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.

Division of Hospital Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.

出版信息

Med Educ Online. 2020 Dec;25(1):1728168. doi: 10.1080/10872981.2020.1728168.

DOI:10.1080/10872981.2020.1728168
PMID:32148177
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7144188/
Abstract

: The arrival of new residents brings challenges for residency programs and residents. Many residency programs conduct orientation sessions to help transition rising supervisory residents into their new roles, but no evaluation of their impact on residents' emotional well-being has been performed.: This study assesses the impact of a half-day orientation retreat on rising internal medicine post-graduate year (PGY) 2 residents' emotions toward PGY2 year and their self-confidence in fulfilling the supervisory resident role.: A survey was administered to a class of rising supervisory residents immediately before and after an orientation retreat in May 2017. The survey provided participants an open-ended prompt to describe their emotions toward PGY2 year and a 5-point Likert scale to rate their confidence in fulfilling supervisory resident roles. Differences were assessed using McNemar's exact and Wilcoxon signed-rank tests, respectively.: Forty-four of 50 (88%) eligible participants completed pre- and post-intervention Likert scales and 40 of 50 (80%) eligible participants completed corresponding emotion sections. Pre-intervention the most common emotions were anxiety (n = 33, 82.5%) and excitement (n = 32, 80.0%). Post-intervention, participants' fear was reduced (45.0% vs 12.0%; p < 0.001). Participants reported greater confidence that internship prepared them for PGY2 year and understanding of triaging and admitting principles (agree or strongly agree from 65.9% to 84.0% and from 25.0% to 68.2%, respectively; p < 0.005 for improvement by Wilcoxon signed-rank for both).: Orientation retreats may be an effective way to reduce fear and demystify the supervisory resident role.

摘要

新居民的到来给住院医师培训计划和住院医师带来了挑战。许多住院医师培训计划会举办迎新会,以帮助即将升任的住院医师过渡到新角色,但尚未评估这些迎新会对住院医师情绪健康的影响。本研究评估了为期半天的迎新静修对即将升任的内科住院医师第二年(PGY2)住院医师情绪和履行监督住院医师角色的自信心的影响。2017 年 5 月,在一次迎新静修会前和会后,向一个即将升任的监督住院医师班级发放了一份调查。该调查为参与者提供了一个开放式提示,以描述他们对 PGY2 年的情绪,并使用 5 分李克特量表对他们履行监督住院医师角色的信心进行评分。分别使用 McNemar 确切检验和 Wilcoxon 符号秩检验评估差异。50 名符合条件的参与者中有 44 名(88%)完成了干预前后的李克特量表,40 名(80%)符合条件的参与者完成了相应的情绪部分。在干预前,最常见的情绪是焦虑(n=33,82.5%)和兴奋(n=32,80.0%)。干预后,参与者的恐惧减少(45.0%对 12.0%;p<0.001)。参与者报告说,实习更能让他们为 PGY2 年做好准备,并且更了解分诊和收治原则(同意或强烈同意从 65.9%增加到 84.0%和从 25.0%增加到 68.2%;Wilcoxon 符号秩检验均为 p<0.005,表明有所改善)。迎新静修可能是减少恐惧和揭开监督住院医师角色神秘面纱的有效方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b151/7144188/0f9780bff819/ZMEO_A_1728168_F0002_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b151/7144188/709e539ae784/ZMEO_A_1728168_F0001_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b151/7144188/0f9780bff819/ZMEO_A_1728168_F0002_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b151/7144188/709e539ae784/ZMEO_A_1728168_F0001_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b151/7144188/0f9780bff819/ZMEO_A_1728168_F0002_B.jpg

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