Warren Jennifer, Plunkett Emma, Rudge James, Stamoulis Christina, Torlinski Tomasz, Tarrant Carolyn, Mullhi Randeep
Anaesthesia and Critical Care Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK.
Social Science Applied to Healthcare Improvement Research (SAPPHIRE) Group, Health Sciences, University of Leicester, Leicester, Leicestershire, UK.
BMJ Open. 2021 May 25;11(5):e049437. doi: 10.1136/bmjopen-2021-049437.
Concern about trainee work-related well-being has been raised in recent years and is the subject of several reviews, reports and research studies. This study aimed to understand the experiences of trainees working in a large intensive care unit during the first surge of the COVID-19 pandemic from an educational and operational perspective in order to highlight what worked and what could be improved.
A qualitative study using peer-to-peer semistructured interviews, developed using appreciative inquiry methodology, was conducted during July 2020. Responses were analysed using a thematic analysis technique.
A large, tertiary intensive care unit in the UK.
All trainees in anaesthesia and intensive care working on the intensive care unit during the first surge were invited to participate.
Forty interviews were conducted and four over-arching themes were identified. These were: feeling safe and supported; physical demands; the emotional burden of caring; and a sense of fulfilment, value and personal development. Positive aspects of the organisational response to the pandemic included communication, personal protective equipment supply, team working and well-being support. Suggestions for improvement focused on rest facilities, rota patterns and hierarchies, creating opportunities for reflection and ensuring continued educational and training opportunities despite operational demands.
Trainees described opportunities for learning and fulfilment, as well as challenges, in working through a pandemic. Trainees described their needs and how well these were met during the pandemic. Ideas for improvement most frequently related to basic needs including safety and fatigue, but suggestions also related to supporting learning and development. The appreciative inquiry methodology of the project facilitated effective reflection on positive aspects of trainee experiences.
近年来，人们对实习医生与工作相关的幸福感愈发关注，这也是多项综述、报告及研究的主题。本研究旨在从教育和运营角度，了解在新冠疫情首次激增期间，大型重症监护病房实习医生的经历，以突出哪些做法有效以及哪些方面有待改进。
2020年7月开展了一项定性研究，采用基于肯定性探究方法开发的 peer-to-peer 半结构化访谈。运用主题分析技术对回复进行分析。
英国一家大型三级重症监护病房。
邀请了在首次激增期间在重症监护病房工作的所有麻醉和重症监护实习医生参与。
进行了40次访谈，确定了四个总体主题。分别是：感到安全和得到支持；身体需求；护理的情感负担；以及成就感、价值感和个人发展。组织对疫情的应对措施的积极方面包括沟通、个人防护装备供应、团队协作和幸福感支持。改进建议集中在休息设施、排班模式和层级制度，创造反思机会，以及确保尽管有运营需求仍能持续提供教育和培训机会。
实习医生描述了在应对疫情工作中的学习和成就感机会，以及挑战。实习医生阐述了他们的需求以及在疫情期间这些需求得到满足的程度。改进意见大多与安全和疲劳等基本需求相关，但也有关于支持学习和发展的建议。该项目的肯定性探究方法有助于对实习医生经历的积极方面进行有效反思。
