美国和加拿大医学院健康项目全国调查。

National Survey of Wellness Programs in U.S. and Canadian Medical Schools.

作者信息

Schutt Alison, Chretien Katherine C, Woodruff James N, Press Valerie G, Vela Monica, Lee Wei Wei

机构信息

A. Schutt is a medical student, University of Chicago Pritzker School of Medicine, University of Chicago, Chicago, Illinois.

K.C. Chretien is professor of medicine and associate dean, Student Affairs, The George Washington University School of Medicine and Health Sciences, Washington, DC.

出版信息

Acad Med. 2021 May 1;96(5):728-735. doi: 10.1097/ACM.0000000000003953.

DOI:10.1097/ACM.0000000000003953

PMID:33538474

Abstract

PURPOSE

To describe the prevalence and scope of wellness programs at U.S. and Canadian medical schools.

METHOD

In July 2019, the authors surveyed 159 U.S. and Canadian medical schools regarding the prevalence, structure, and scope of their wellness programs. They inquired about the scope of programming, mental health initiatives, and evaluation strategies.

RESULTS

Of the 159 schools, 104 responded (65%). Ninety schools (93%, 90/97) had a formal wellness program, and across 75 schools, the mean full-time equivalent (FTE) support for leadership was 0.77 (standard deviation [SD] 0.76). The wellness budget did not correlate with school type or size (respectively, P = .24 and P = .88). Most schools reported adequate preventative programming (62%, 53/85), reactive programming (86%, 73/85), and cultural programming (52%, 44/85), but most reported too little focus on structural programming (56%, 48/85). The most commonly reported barrier was lack of financial support (52%, 45/86), followed by lack of administrative support (35%, 30/86). Most schools (65%, 55/84) reported in-house mental health professionals with dedicated time to see medical students; across 43 schools, overall mean FTE for mental health professions was 1.62 (SD 1.41) and mean FTE per student enrolled was 0.0024 (SD 0.0019). Most schools (62%, 52/84) evaluated their wellness programs; they used the Association of American Medical Colleges Graduation Questionnaire (83%, 43/52) and/or annual student surveys (62%, 32/52). The most commonly reported barrier to evaluation was lack of time (54%, 45/84), followed by lack of administrative support (43%, 36/84).

CONCLUSIONS

Wellness programs are widely established at U.S. and Canadian medical schools, and most focus on preventative and reactive programming, as opposed to structural programming. Rigorous evaluation of the effectiveness of programs on student well-being is needed to inform resource allocation and program development. Schools should ensure adequate financial and administrative support to promote students' well-being and success.

摘要

目的

描述美国和加拿大医学院校健康促进项目的普及情况和范围。

方法

2019年7月，作者就美国和加拿大159所医学院校健康促进项目的普及情况、结构和范围进行了调查。他们询问了项目规划范围、心理健康举措和评估策略。

结果

159所学校中，104所做出了回应（65%）。90所学校（93%，90/97）设有正式的健康促进项目，75所学校中，领导层面全职等效人员（FTE）的平均支持力度为0.77（标准差[SD]0.76）。健康促进预算与学校类型或规模均无关联（P值分别为0.24和0.88）。大多数学校报告称有足够的预防性项目（62%，53/85）、反应性项目（86%，73/85）和文化项目（52%，44/85），但大多数学校表示对结构性项目的关注过少（56%，48/85）。最常报告的障碍是缺乏资金支持（52%，45/86），其次是缺乏行政支持（35%，30/86）。大多数学校（65%，55/84）报告有校内心理健康专业人员专门安排时间为医学生提供服务；43所学校中，心理健康专业人员的总体平均全职等效人员数为1.62（标准差1.41），每名注册学生的平均全职等效人员数为0.0024（标准差0.0019）。大多数学校（62%，52/84）对其健康促进项目进行了评估；他们使用了美国医学院协会毕业调查问卷（83%，43/52）和/或年度学生调查（62%，32/52）。最常报告的评估障碍是缺乏时间（54%，45/84），其次是缺乏行政支持（43%，36/84）。