Bamdad Michaela C, Vitous C Ann, Rivard Samantha J, Anderson Maia, Lussiez Alisha, De Roo Ana C, Englesbe Michael J, Suwanabol Pasithorn A
Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI.
Department of Surgery, University of Michigan, Ann Arbor, MI.
Ann Surg Open. 2022 Apr 1;3(2):e139. doi: 10.1097/AS9.0000000000000139. eCollection 2022 Jun.
In recent years, there has been increasing focus on the well-being of resident physicians. Considering the persistent problem of burnout and attrition particularly among surgical trainees, this is a well-warranted and laudable area of focus. However, despite the widespread adoption of resources available to residents through individual institutions, there is little understanding of how and why these resources are engaged or not during particularly vulnerable moments, such as following an unwanted patient event including postoperative complications and deaths.
This qualitative study explored access to and usage of resources to promote well-being following an unwanted patient outcome through semi-structured interviews of 28 general surgery residents from 14 residency programs across the United States, including community, academic, and hybrid programs. A qualitative descriptive approach was used to analyze transcripts.
Residents described 3 main types of institutional resources available to them to promote well-being, including support from and Residents also described important barriers to use for each of these resources, which limited their access and value of these resources. Finally, residents shared their for future initiatives, including additional protected time off during weekdays and regular usage of structured debrief sessions following adverse patient outcomes.
While institutional resources are commonly available to surgery residents, there remain important limitations and barriers to use, which may limit their effectiveness in supporting resident well-being in times of need. These barriers should be addressed at the program level to improve services and accessibility for residents.
近年来，住院医师的福祉越来越受到关注。鉴于倦怠和人员流失问题持续存在，尤其是在外科住院医师培训学员中，这是一个很有必要且值得称赞的关注领域。然而，尽管各机构为住院医师提供的资源已被广泛采用，但对于在特别脆弱的时刻，例如在发生不良患者事件（包括术后并发症和死亡）之后，这些资源是如何以及为何被使用或未被使用，人们却知之甚少。
本定性研究通过对来自美国14个住院医师培训项目（包括社区、学术和混合型项目）的28名普通外科住院医师进行半结构化访谈，探讨了在出现不良患者结局后获取和使用促进福祉资源的情况。采用定性描述方法分析访谈记录。
住院医师描述了可用于促进福祉的3种主要机构资源类型，包括来自 的支持和 住院医师还描述了使用每种资源的重要障碍，这些障碍限制了他们获取这些资源以及这些资源的价值。最后，住院医师分享了他们对未来举措的 ，包括工作日额外的受保护休假时间以及在不良患者结局后定期使用结构化汇报会议。
虽然手术住院医师通常可以获得机构资源，但在使用方面仍存在重要的限制和障碍，这可能会限制这些资源在需要时支持住院医师福祉的有效性。这些障碍应在项目层面加以解决，以改善为住院医师提供的服务和可及性。
