Kemp Michael T, Evans Julie, Rivard Samantha J, Sharma Sriganesh B, Williams Aaron M, Coleman Dawn M, Dimick Justin, Sandhu Gurjit
Department of Surgery, University of Michigan, Ann Arbor, MI.
Ann Surg. 2022 Apr 1;275(4):673-678. doi: 10.1097/SLA.0000000000005230.
The aim of this study was to obtain novel perspectives regarding the effects that surgical training has on the well-being of trainees.
Improving trainee well-being is a national concern given high rates of burnout, depression, and suicide among physicians. Supporters of surgical trainees may offer new perspectives regarding the effects of surgical training and point to strategies to optimize trainee wellness.
This qualitative study employs semi-structured interviews of 32 support persons of trainees at a single tertiary care center with multiple surgical training programs. Interviews focused on perspectives related to supporting a surgical trainee. Interview transcripts underwent qualitative analysis with semantic and conceptual coding. Themes related to effects of training on trainee wellness are reported.
Four themes were identified: Who Can Endure the Most Hardship?-trainee attributes and programmatic factors contribute to trainees feeling the need to constantly endure the most hardship; Consequences of Hardship-constantly enduring hardships has significant negative effects on wellness; Trainees are Humans-trainees are people with basic human needs, especially the need for worth; Research Time as Refuge-dedicated research time is treated as an oasis away from clinical hardships.
Perspectives from support persons can offer valuable insight into the wellness needs of surgical trainees. According to support persons, surgical training profoundly negatively impacts trainee wellness. Unlike during clinical training, dedicated research time is a period during which wellness can be prioritized. Programs should provide greater attention to mitigating the negative ramifications of surgical training and promoting wellness in a longitudinal fashion throughout training.
本研究旨在获取有关外科培训对学员幸福感影响的新观点。
鉴于医生中倦怠、抑郁和自杀率较高，改善学员幸福感是一项全国性关注的问题。外科培训学员的支持者可能会就外科培训的影响提供新观点，并指出优化学员健康状况的策略。
这项定性研究采用对一家拥有多个外科培训项目的单一三级护理中心的32名学员支持者进行半结构化访谈的方法。访谈重点关注与支持外科培训学员相关的观点。访谈记录经过语义和概念编码的定性分析。报告了与培训对学员健康影响相关的主题。
确定了四个主题：谁能承受最大的困难？——学员的特质和项目因素导致学员觉得需要不断承受最大的困难；困难的后果——不断承受困难对健康有重大负面影响；学员也是人——学员是有基本人类需求的人，尤其是对价值的需求；作为避难所的研究时间——专门的研究时间被视为远离临床困难的绿洲。
支持者的观点可以为外科培训学员的健康需求提供有价值的见解。根据支持者的说法，外科培训对学员的健康有深远的负面影响。与临床培训期间不同，专门的研究时间是可以优先考虑健康的时期。各项目应更加关注减轻外科培训的负面影响，并在整个培训过程中以纵向方式促进健康。
