Centre for Medical Education, University of Dundee, Dundee, UK.
School of Medicine, University of St Andrews, St Andrews, UK.
Med Educ. 2022 May;56(5):516-526. doi: 10.1111/medu.14698. Epub 2021 Dec 9.
Supporting doctors' wellbeing is crucial for medical education to help minimise negative long-term impacts on medical workforce retention and ultimately patient care. There is limited study of how doctors' transitions experiences impact wellbeing, particularly socially and culturally. Multiple Multidimensional Transitions (MMT) theory views transitions as dynamic, incorporating multiple contexts and multiple domains. Using MMT as our lens, we report a qualitative analysis of how transitions experienced by doctors during the pandemic impacted on social and cultural aspects of wellbeing.
Longitudinal narrative inquiry was employed, using interviews and audio-diaries. Data were collected over 6 months in three phases: (i) interviews with doctors from across the career spectrum (n = 98); (ii) longitudinal audio-diaries for 2-4 months (n = 71); (iii) second interviews (n = 83). Data were analysed abductively, narrowing focus to factors important to social and cultural wellbeing.
Doctors described experiencing multiple interacting transitions triggered by the pandemic in multiple contexts (workplace, role, homelife and education). Patterns identifiable across the dataset allowed us to explore social and cultural wellbeing crosscutting beyond individual experience. Three critical factors contributed to social and cultural wellbeing both positively and negatively: being heard (e.g., by colleagues asking how they are); being valued (e.g., removal of rest spaces by organisations showing lack of value); and being supported (e.g., through regular briefing by education bodies).
This study is the first to longitudinally explore the multiple-multidimensional transitions experienced by doctors during the COVID-19 pandemic. Our data analysis helped us move beyond existing perceptions around wellbeing and articulate multiple factors that contribute to social and cultural wellbeing. It is vital that medical educators consider the learning from these experiences to help pinpoint what aspects of support might be beneficial to trainee doctors and their trainers. This study forms the basis for developing evidenced-based interventions that ensure doctors are heard, valued and supported.
支持医生的幸福感对于医学教育至关重要，有助于最大限度地减少对医疗劳动力保留的负面长期影响，最终影响患者护理。关于医生的过渡经历如何影响幸福感的研究有限，特别是在社会和文化方面。多种多维过渡（MMT）理论将过渡视为动态的，包含多个背景和多个领域。我们使用 MMT 作为视角，报告了一项关于医生在大流行期间的过渡经历如何影响幸福感的社会和文化方面的定性分析。
采用纵向叙事研究，使用访谈和音频日记。数据在三个阶段收集了 6 个月：（i）对来自职业生涯各个阶段的医生进行访谈（n=98）；（ii）进行 2-4 个月的纵向音频日记（n=71）；（iii）第二次访谈（n=83）。数据采用非系统分析进行分析，缩小重点关注对社会和文化幸福感重要的因素。
医生描述了在多个背景下（工作场所、角色、家庭生活和教育）经历了由大流行引发的多种相互作用的过渡。在整个数据集内可识别的模式使我们能够探索跨越个人经验的社会和文化幸福感。有三个关键因素对社会和文化幸福感产生了积极和消极的影响：被倾听（例如，同事询问他们的情况）；被重视（例如，组织取消休息空间表明缺乏价值）；和得到支持（例如，教育机构定期通报）。
这项研究是首次纵向探索医生在 COVID-19 大流行期间经历的多种多维过渡。我们的数据分析帮助我们超越了现有关于幸福感的认识，并阐明了有助于社会和文化幸福感的多个因素。医学教育工作者必须考虑从这些经验中学习，以帮助确定哪些支持方面可能对受训医生及其培训师有益。本研究为开发基于证据的干预措施奠定了基础，以确保医生得到倾听、重视和支持。
