Department of Pediatrics, The Ohio State University (SM Lauden, MM Faust, and JD Mahan), Columbus, Ohio.
Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati (PM Wilson and CJ Schubert), Cincinnati, Ohio.
Acad Pediatr. 2020 Nov-Dec;20(8):1192-1197. doi: 10.1016/j.acap.2020.05.006. Epub 2020 May 11.
Describe the demographics of pediatric and internal medicine/pediatric residents participating in global health (GH) experiences and examine relationships between GH involvement and self-perceived burnout, resilience, mindfulness, empathy, and spirituality.
The Pediatric Resident Burnout and Resilience Study Consortium developed a national longitudinal study through collaboration with the Association of Pediatric Program Directors' Longitudinal Educational Assessment Research Network. Electronic surveys were administered to pediatric trainees annually (2016-2018). GH and well-being data were extracted. Descriptive statistics were calculated.
Of 9653 eligible pediatric and medicine/pediatric residents from 55 institutions, 6150 responded to the survey in 1 or more years, with average completion rate of 63.7% over a 3-year period. Controlling for repeat survey-takers, 12.7% (536/4213) of residents reported involvement in a GH-specific pathway, curricula, or track. GH participants were significantly more likely to be unmarried (P < .001), childless (P = .003), and medicine/pediatric trainees (P < .001). Controlling for repeated measures and demographic factors, GH participants demonstrated higher levels of empathic concern (P < .001) and higher spirituality scores in 2 of 3 domains (P < .01/<.05). GH involvement was not associated with lower reports of burnout or improved resilience/mindfulness.
Although GH involvement is associated with increased levels of empathy and spirituality, it was not protective against burnout in this study. This highlights the need to study and promote the well-being of all residents, and perhaps especially those experiencing the challenges of working in low-resource settings. Future efforts should determine the impact of predeparture training, programmatic support, and post-trip debriefing on resident well-being.
描述参与全球健康（GH）活动的儿科和内科/儿科住院医师的人口统计学特征，并研究 GH 参与与自我感知的倦怠、适应力、正念、同理心和灵性之间的关系。
儿科住院医师倦怠和适应力研究联盟通过与儿科项目主任协会纵向教育评估研究网络合作，开展了一项全国性的纵向研究。每年向儿科受训者进行电子调查（2016-2018 年）。提取 GH 和幸福感数据。计算描述性统计数据。
在来自 55 个机构的 9653 名符合条件的儿科和内科/儿科住院医师中，有 6150 名在 1 年或多年内对调查做出了回应，3 年内的平均完成率为 63.7%。在控制重复调查者的情况下，有 12.7%（536/4213）的住院医师报告参与了特定于 GH 的途径、课程或轨道。GH 参与者未婚的可能性明显更高（P<0.001）、无子女（P=0.003）、且更有可能是内科/儿科住院医师（P<0.001）。在控制重复测量和人口统计学因素的情况下，GH 参与者在同理心关怀的 2 个领域中表现出更高的水平（P<0.001），在 3 个领域中的 2 个领域中表现出更高的灵性分数（P<0.01/<0.05）。GH 参与与倦怠报告的降低或适应力/正念的提高无关。
尽管 GH 参与与同理心和灵性水平的提高有关，但在这项研究中，它不能预防倦怠。这凸显了研究和促进所有住院医师幸福感的必要性，尤其是那些在资源匮乏环境中工作面临挑战的住院医师。未来的研究应确定出发前培训、项目支持和旅行后汇报对住院医师幸福感的影响。
