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泌尿外科住院医师培训项目中应对住院医师职业倦怠的创新方法。

Innovative Approaches to Battling Resident Burnout in a Urology Residency Program.

作者信息

Anaissie James, Popat Shreeya, Mayer Wesley A, Taylor Jennifer M

机构信息

Scott Department of Urology, Baylor College of Medicine, Houston, Texas.

出版信息

Urol Pract. 2021 May;8(3):387-392. doi: 10.1097/UPJ.0000000000000215. Epub 2021 Mar 22.

DOI:10.1097/UPJ.0000000000000215
PMID:37145657
Abstract

INTRODUCTION

Data suggest many U.S. physicians experience burnout, affecting up to 65% of U.S. urology resident physicians. We implemented a multifaceted Urology Resident Wellness Curriculum and measured its effect on burnout reported among our trainees.

METHODS

We created a 5-pronged Resident Wellness Curriculum: 1) faculty-sponsored Resident Wellness Fund, 2) social groups between 1 faculty and 2-3 trainees, 3) one-on-one structured mentorship, 4) resident-organized social outings using the Resident Wellness Fund, and 5) wellness education. We administered 2 validated burnout questionnaires, the Maslach Burnout Index-Human Services Survey and the Expanded Mayo Physician Well Being Index, to our resident physicians at 4 time points, immediately before and following curriculum implementation. At study conclusion, resident physicians were asked to rank the most meaningful interventions.

RESULTS

At 4 timepoints over 3 academic years, 54 completed instruments were collected from 32 unique resident physicians. Initial Maslach Burnout Index survey data indicated high levels of Depersonalization and Emotional Exhaustion with moderate levels of Personal Accomplishment. Over the study period, there was improvement in Depersonalization from high to moderate (28% decrease, p=0.04), improvement in Emotional Exhaustion from high to moderate (20% decrease, p=0.15) and preserved moderate Personal Accomplishment. The average Physician Well Being Index score decreased by 52% (p=0.006), demonstrating decreased levels of distress. Resident-organized social outings were ranked as the most meaningful intervention, with 63% of participants ranking it first.

CONCLUSIONS

Rates of urology resident physician burnout were observed to be high at baseline, but improved significantly after introduction of a purposeful Resident Wellness Curriculum.

摘要

引言

数据显示,许多美国医生都有职业倦怠问题,高达65%的美国泌尿外科住院医师受此影响。我们实施了一项多方面的泌尿外科住院医师健康课程,并评估了其对我们学员报告的职业倦怠的影响。

方法

我们创建了一个五管齐下的住院医师健康课程:1)由教员赞助的住院医师健康基金;2)1名教员与2至3名学员组成的社交小组;3)一对一的结构化指导;4)住院医师利用健康基金组织的社交活动;5)健康教育培训。我们在课程实施前和实施后的4个时间点,向住院医师发放了2份经过验证的职业倦怠问卷,即马氏职业倦怠量表-人类服务调查和扩展梅奥医生幸福感指数。在研究结束时,要求住院医师对最有意义的干预措施进行排名。

结果

在3个学年的4个时间点,从32名不同的住院医师那里收集到了54份完整的问卷。最初的马氏职业倦怠量表调查数据显示,去人格化和情感耗竭程度较高,个人成就感程度中等。在研究期间,去人格化程度从高到中有所改善(下降28%,p=0.04),情感耗竭程度从高到中有所改善(下降20%,p=0.15),个人成就感保持在中等水平。医生幸福感指数的平均得分下降了52%(p=0.006),表明痛苦程度降低。住院医师组织的社交活动被评为最有意义的干预措施,63%的参与者将其排在首位。

结论

在基线时,泌尿外科住院医师的职业倦怠率较高,但在引入有针对性的住院医师健康课程后有显著改善。

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