Song Yun, Swendiman Robert A, Shannon Adrienne B, Torres-Landa Samuel, Khan Faisal N, Williams Noel N, Dumon Kristoffel R, Brooks Ari D, DeMatteo Ronald P, Aarons Cary B
Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Department of Surgery, Oregon Health and Science University, Portland, Oregon.
J Surg Educ. 2020 Nov-Dec;77(6):1481-1489. doi: 10.1016/j.jsurg.2020.04.014. Epub 2020 May 20.
The purpose of this study was to evaluate the use of a professionally trained, resilience coach for surgical interns.
Mixed-methods study with pre- and postcoaching quantitative surveys measuring burnout and resilience factors and semistructured interviews.
General, Vascular, Cardiac, Plastic, and Urologic Surgery residencies at a tertiary academic center.
Categorical and preliminary interns (N = 25) participated in a year-long, 8-session resilience coaching program for the academic year 2018 to 2019.
Program participants included 17 (68%) men and 8 (32%) women. The precoaching survey administered to interns before the start of the program identified 60% at risk of burnout as measured by the Abbreviated Maslach Burnout Inventory. The mean (standard deviation) Brief Resilience Scale score was 3.8 (0.8), with a trend toward a higher score (greater resilience) among men compared to women (4.1 [0.7] vs 3.4 [1.0], p = 0.10). Following the completion of the coaching program, the mean (standard deviation) Brief Resilience Scale score increased significantly from 3.8 [0.8] to 4.2 [0.7] p = 0.002). There were no changes in other parameters measuring burnout, satisfaction with life, or positive/negative affect. In semistructured interviews (N = 16/25 participants), most interns believed the coaching experience provided useful skills, but expressed concern about the durability of a 1-year intervention. Additionally, leadership-driven wellness at work, including optimizing team dynamics and purpose-driven engagement, were emphasized.
About 60% of new interns at our institution were at risk of burnout. The coaching program was viewed positively and was effective in improving resilience. While this intervention was a useful first step, it should be incorporated into a longitudinal wellness program for the duration of surgical training.
本研究旨在评估为外科实习医生配备一名经过专业培训的心理韧性教练的效果。
采用混合方法研究，在辅导前后进行定量调查以测量职业倦怠和心理韧性因素，并进行半结构化访谈。
一所三级学术中心的普通外科、血管外科、心脏外科、整形外科和泌尿外科住院医师培训项目。
分类和初级实习医生（N = 25）参加了2018至2019学年为期一年、共8节的心理韧性辅导课程。
项目参与者包括17名（68%）男性和8名（32%）女性。在项目开始前对实习医生进行的辅导前调查显示，根据简版马氏职业倦怠量表测量，60%的人有职业倦怠风险。简明心理韧性量表的平均（标准差）得分是3.8（0.8），男性得分有高于女性的趋势（更具心理韧性）（4.1 [0.7] 对3.4 [1.0]，p = 0.10）。辅导课程结束后，简明心理韧性量表的平均（标准差）得分从3.8 [0.8] 显著提高到4.2 [0.7]（p = 0.002）。在测量职业倦怠、生活满意度或积极/消极情绪的其他参数方面没有变化。在半结构化访谈中（N = 16/25名参与者），大多数实习医生认为辅导经历提供了有用的技能，但对为期1年的干预效果的持久性表示担忧。此外，还强调了领导推动的工作场所健康，包括优化团队动态和目标驱动的参与度。
我们机构约60%的新实习医生有职业倦怠风险。该辅导项目得到了积极评价，并且在提高心理韧性方面有效。虽然这一干预是有益的第一步，但应将其纳入外科培训期间的长期健康项目中。
