Third-Year Resident, Department of Surgery, University of New Mexico School of Medicine.
Fourth-Year Medical Student, Baylor College of Medicine.
MedEdPORTAL. 2022 Apr 26;18:11245. doi: 10.15766/mep_2374-8265.11245. eCollection 2022.
There is a lack of curricula addressing the alarming rates of resident physician mistreatment. As the ACGME works to address diversity, equity, and inclusion in GME, there has been increasing attention paid to the issue of mistreatment. Previous studies have noted a high prevalence of mistreatment within GME. Despite this, there are few published interventions to address the mistreatment of residents. We developed a workshop for residents to provide an overview of mistreatment in residency and teach them REWIND (relax, express, why, inquire, negotiate, determine), a communication tool to address mistreatment directly.
We designed a 60-minute workshop for residents with didactics on mistreatment in GME, followed by three case discussions. Four case scenarios were developed to represent different types of mistreatment and situations. We implemented the workshop twice and asked participants to self-rate proficiency around the workshop objectives with pre- and postsurveys.
A total of 11 GME learners completed both the pre- and postsurveys between the two workshop implementations. GME learners who responded demonstrated significantly higher self-rated proficiency on each objective postworkshop compared to preworkshop ( < .05). Free responses on the survey demonstrated that participants particularly enjoyed the case discussions and wanted more practice with REWIND.
Our workshop improved participant self-rated proficiency around the mistreatment of resident physicians. The workshop can be used in the future as part of a multifaceted institutional response to mistreatment.
目前缺乏专门针对住院医师受虐待这一令人震惊的发生率的课程。随着 ACGME 努力解决医学教育中的多样性、公平性和包容性问题，人们越来越关注虐待问题。先前的研究已经注意到医学教育中存在着高比例的虐待现象。尽管如此，很少有针对居民虐待问题的已发表干预措施。我们为住院医师开发了一个讲习班，以提供住院医师虐待方面的概述，并教授他们使用 REWIND（放松、表达、原因、询问、协商、决定），这是一种直接解决虐待问题的沟通工具。
我们为住院医师设计了一个 60 分钟的讲习班，内容包括医学教育中的虐待问题，然后进行三次案例讨论。我们开发了四个案例场景，以代表不同类型的虐待和情况。我们实施了两次讲习班，并要求参与者在参加前后的调查中自我评估对讲习班目标的熟练程度。
共有 11 名 GME 学习者在两次讲习班实施之间完成了前后调查。回复调查的 GME 学习者在每个目标上的自我评估熟练度在课后都明显高于课前（<0.05）。调查中的自由回复表明，参与者特别喜欢案例讨论，并希望更多地练习使用 REWIND。
我们的讲习班提高了参与者对住院医师虐待问题的自我评估熟练度。该讲习班可作为未来机构针对虐待问题的多方面应对措施的一部分。
