Shaniuk Paul M
Louis Stokes Cleveland Veterans Affairs Medical Center, OH, USA.
Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Linacre Q. 2020 Nov;87(4):399-406. doi: 10.1177/0024363920920400. Epub 2020 May 7.
Burnout is highly prevalent among physicians and is associated with negative patient outcomes. Furthermore, medical training is a particularly vulnerable time as studies show that medical students, residents, and fellows experience burnout and emotional exhaustion at higher rates than both the general population and physicians in practice. Multiple recent studies have demonstrated the practice of religion and spirituality to be protective against burnout in trainees. Can Catholic academic physicians transfer these protective benefits of religion and spirituality to their trainees, who are at the highest risk, and who may or may not share their faith? An ancient Catholic tradition, the Seven Spiritual Works of Mercy, may hold the key. The Spiritual Works of Mercy are listed by the US Conference of Catholic Bishops as Counseling the Doubtful, Instructing the Ignorant, Admonishing the Sinner, Comforting the Sorrowful, Forgiving Injuries, Bearing Wrongs Patiently, and Praying for the Living and the Dead. Using this as a framework, examples of evidenced-based actions from the literature that have been shown to either prevent burnout or to improve the day-to-day experience of medical trainees were discussed. Examples include encouraging trainees to express doubts or to debrief after difficult and saddening cases. Academic physicians can provide instruction, feedback, or admonishment; demonstrate forgiveness of errors; and model the way in bearing wrongs patiently, all while uplifting their trainees in prayer. The Spiritual Works of Mercy can thus become a framework for academic physicians to uplift their trainees' spirits and potentially prevent against burnout.
Burnout is highly prevalent in medical students and in doctors during their residency or fellowship training, but multiple studies have shown regular practice of religion and spirituality to be protective against burnout. The Seven Spiritual Works of Mercy (Counsel the Doubtful, Instruct the Ignorant, Admonish the Sinner, Comfort the Sorrowful, Forgive All Injuries, Bear Wrongs Patiently and Pray for the Living and the Dead) provide a framework of powerful examples for teaching physicians, particularly Catholic teaching physicians, to uplift their students and potentially transfer this benefit to reduce their students' risk for burnout.
职业倦怠在医生中极为普遍,且与负面的患者治疗结果相关。此外,医学培训阶段是一个特别容易出现问题的时期,因为研究表明,医学生、住院医师和研究员经历职业倦怠和情感耗竭的比例高于普通人群和在职医生。最近的多项研究表明,宗教和精神信仰活动对实习生预防职业倦怠具有保护作用。天主教的学术医生能否将宗教和精神信仰的这些保护作用传递给风险最高、且可能与他们有相同信仰或没有相同信仰的实习生呢?古老的天主教传统——“七件慈悲善事”或许是关键所在。美国天主教主教会议列出的“七件慈悲善事”为:劝告怀疑者、教导无知者、 admonish the sinner(此处英文原文有误,正确应为“Admonish the Sinner”,意为告诫罪人)、安慰悲伤者、原谅伤害、耐心忍受冤屈、为生者和死者祈祷。以此为框架,讨论了文献中已被证明可预防职业倦怠或改善医学实习生日常体验的循证行动示例。示例包括鼓励实习生表达疑虑或在处理困难和悲伤的病例后进行汇报。学术医生可以提供指导、反馈或告诫;表现出对错误的宽容;并耐心忍受冤屈树立榜样,同时在祈祷中鼓舞实习生。因此,“七件慈悲善事”可以成为学术医生提升实习生精神状态并可能预防职业倦怠的框架。
职业倦怠在医学生以及住院医师或研究员培训阶段的医生中极为普遍,但多项研究表明,定期进行宗教和精神信仰活动可预防职业倦怠。“七件慈悲善事”(劝告怀疑者、教导无知者、告诫罪人、安慰悲伤者、原谅所有伤害、耐心忍受冤屈、为生者和死者祈祷)为教学医生,尤其是天主教教学医生提供了一系列有力的示例框架,以提升他们的学生,并有可能传递这种益处,降低学生职业倦怠的风险。