Ricker Mari, Brooks Audrey J, Bodine Sarah, Lebensohn Patricia, Maizes Victoria
Department of Family and Community Medicine, University of Arizona College of Medicine, Tucson, AZ.
University of Arizona Andrew Weil Center for Integrative Medicine, Tucson, AZ.
Fam Med. 2021 Feb;53(2):123-128. doi: 10.22454/FamMed.2021.314886.
Wellness in residency has come to the forefront of national graduate medical education initiatives. Exponential growth in knowledge and skill development occurs under immense pressures, with physical, mental, and emotional stressors putting residents at burnout risk. The Accreditation Council for Graduate Medical Education requires programs to attend to resident wellness, providing the structure, environment, and resources to address burnout. This study's purpose was to evaluate the Andrew Weil Center for Integrative Medicine online Physician Well-being Course (PWC) with incoming postgraduate year-1 (PGY-1) residents in multiple residencies across a single health care system. The PWC teaches the learner strategies for building resilience, managing stress, identifying signs of burnout, and mindfulness practices including a self-selected daily 10-minute resiliency activity (meditation, gratitude journaling, and finding meaning journaling) for 14 days.
Incoming PGY-1 residents were enrolled in PWC 1 month prior to 2018 orientation. Validated measures of resiliency, burnout and gratitude were completed pre- and postcourse. We assessed pre/postcourse changes with paired t tests. We asked participants whether they incorporated any wellness behavior changes postcourse.
Almost two-thirds of the incoming trainees completed the course (n=53/87, 61%). We found significant improvements (P<.05) for resiliency and burnout (emotional exhaustion, depersonalization). Gratitude did not change. The personal accomplishment burnout scale declined. The most frequently reported wellness behaviors were in the area of sleep, exercise, and diet.
Resiliency, emotional exhaustion, and depersonalization improved, personal accomplishment declined, while gratitude remained the same. This project demonstrates an accessible and scalable approach to teaching well-being to incoming residents.
住院医师的健康问题已成为全国毕业后医学教育倡议的重点。在巨大压力下，知识和技能发展呈指数级增长，身体、心理和情绪压力源使住院医师面临职业倦怠风险。毕业后医学教育认证委员会要求各项目关注住院医师的健康，提供应对职业倦怠的架构、环境和资源。本研究的目的是在单一医疗系统的多个住院医师培训项目中，对即将入学的一年级住院医师（PGY-1）评估安德鲁·韦尔综合医学中心的在线医师健康课程（PWC）。该PWC向学习者传授培养恢复力、管理压力、识别职业倦怠迹象的策略，以及正念练习，包括为期14天的自我选择的每日10分钟恢复力活动（冥想、感恩日记和寻找意义日记）。
即将入学的PGY-1住院医师在2018年入职培训前1个月参加PWC。在课程前后完成对恢复力、职业倦怠和感恩的有效测量。我们用配对t检验评估课程前后的变化。我们询问参与者课程结束后是否有任何健康行为的改变。
近三分之二的新学员完成了课程（n=53/87，61%）。我们发现恢复力和职业倦怠（情绪耗竭、去个性化）有显著改善（P<0.05）。感恩没有变化。个人成就感职业倦怠量表得分下降。最常报告的健康行为在睡眠、锻炼和饮食方面。
恢复力、情绪耗竭和去个性化得到改善，个人成就感下降，而感恩保持不变。该项目展示了一种向新住院医师传授健康知识的可及且可扩展的方法。
