Buchanan Jennie A, Meadows Sarah, Whitehead Jason, Sungar W Gannon, Angerhofer Christy, Nussbaum Abraham, Blok Barbara, Guth Todd, Bakes Katherine, Millner Malorie, Salazar Lavonne, Stephens Megan, Kaplan Bonnie
Department of Emergency Medicine & Office of Graduate Medical Education Denver Denver Health & Hospital Authority Denver Colorado USA.
Department of Emergency Medicine Aurora University of Colorado Denver Colorado USA.
J Am Coll Emerg Physicians Open. 2023 May 17;4(3):e12971. doi: 10.1002/emp2.12971. eCollection 2023 Jun.
Emergency medicine training is associated with high levels of stress and burnout, which were exacerbated by the COVID-19 pandemic. The pandemic further exposed a mismatch between trainees' mental health needs and timely support services; therefore, the objective of our innovation was to create an opportunity for residents to access a social worker who could provide consistent coaching. The residency leadership team partnered with our graduate medical education (GME) office to identify a clinical social worker and professionally-trained coach to lead sessions. The project was budgeted at an initial cost of $15,000 over 1 year. Residents participated in 49 group and 73 individual sessions. Post implementation in 2021, we compared this intervention to all other wellness initiatives. Resident response rate was 80.88% ( = 55/68) and median interquartile range (IQR) score of the initiative was 2 (1 = detrimental and 4 = beneficial) versus 3.79 (3.69-3.88) the median IQR of all wellness initiatives. A notable number, 22%, rated the program as detrimental, which could be related to summary comments regarding ability to attend sessions, lack of session structure, loss of personal/educational time, and capacity of the social worker to relate with them. Summary comments also revealed the innovation was useful, with individual sessions preferred to group sessions. Application of a social worker coaching program in an emergency medicine residency program appears to be a feasible novel intervention. Lessons learned after implementation include the importance of recruiting someone with emergency department/GME experience, orienting them to culture before implementation and framing coaching as an integrated residency resource.
急诊医学培训伴随着高水平的压力和职业倦怠，而新冠疫情加剧了这些问题。疫情进一步暴露了学员心理健康需求与及时支持服务之间的不匹配；因此，我们创新的目标是为住院医师创造机会，让他们能够接触到一位可以提供持续指导的社会工作者。住院医师培训领导团队与我们的毕业后医学教育（GME）办公室合作，确定了一名临床社会工作者和一名经过专业培训的教练来主持课程。该项目的初始预算为一年15,000美元。住院医师参加了49次小组课程和73次个人课程。在2021年实施后，我们将这一干预措施与所有其他健康倡议进行了比较。住院医师的回应率为80.88%（n = 55/68），该倡议的中位数四分位间距（IQR）评分为2（1 = 有害，4 = 有益），而所有健康倡议的中位数IQR评分为3.79（3.69 - 3.88）。值得注意的是，22%的人将该项目评为有害，这可能与关于参加课程的能力、课程缺乏结构、个人/教育时间的损失以及社会工作者与他们沟通能力的总结评论有关。总结评论还表明该创新是有用的，个人课程比小组课程更受欢迎。在急诊医学住院医师培训项目中应用社会工作者指导计划似乎是一种可行的新型干预措施。实施后吸取的经验教训包括招募具有急诊科/GME经验的人的重要性、在实施前让他们了解文化以及将指导构建为一种综合的住院医师培训资源。
