Shaker Lana, Amilcar Cindy, Kothari Neil, Murano Tiffany
Hackensack University Medical Center, Hackensack, New Jersey.
Department of Emergency Medicine, University of Texas Health-McGovern Medical School, Houston, Texas.
J Emerg Med. 2023 Jul;65(1):e41-e49. doi: 10.1016/j.jemermed.2023.04.008. Epub 2023 Apr 19.
Remediation of medical trainees is a universal challenge, yet studies show that many residents will need remediation to improve performance. Current literature discusses the importance and processes of remediation and investigates how to recognize residents needing remediation. However, little is known about trainees' attitudes and perception of remediation.
To assess trainees' knowledge of remediation as well as their attitudes and perceptions toward remediation and its process. We hypothesized that trainees have limited knowledge and a negative perception of remediation.
A cross-sectional anonymous electronic survey was sent to all graduate medical education trainees at a single institution.
The survey was completed by 132/1095 (12.1%) trainees. Of the respondents, 7.6% were not familiar with the term "remediation." Trainees' knowledge of remediation processes was variable, and they reported overwhelmingly negative thoughts and attitudes toward remediation. Shame was felt by 97/132 (73.5%), 71/132 (53.8%) felt disadvantaged, and 121/132 (91.7%) viewed the term "remediation" negatively. Most trainees felt using a more positive term would improve perceptions, and 124/132 (93.9%) felt residents should be involved in creating individualized remediation plans. Open-ended responses on reactions to being placed on remediation included disappointment, shame, incompetency, anxiety and worry, embarrassment, unhappiness, suicidality, worthlessness, sense of failure, and doubting one's capabilities as a physician.
Trainees have limited knowledge and understanding of remediation and strong negative perceptions and attitudes toward the remediation process. Trainees suggested that reframing of remediation using more positive terminology and including residents in creating individualized plans, may improve attitudes and perceptions of this process.
对医学实习生进行补救是一项全球性挑战，但研究表明，许多住院医师需要补救以提高表现。当前文献讨论了补救的重要性和过程，并研究了如何识别需要补救的住院医师。然而，对于实习生对补救的态度和看法知之甚少。
评估实习生对补救的了解以及他们对补救及其过程的态度和看法。我们假设实习生对补救的了解有限且对其持负面看法。
向一所机构的所有毕业后医学教育实习生发送了一份横断面匿名电子调查问卷。
1095名实习生中有132名（12.1%）完成了调查。在受访者中，7.6%不熟悉“补救”一词。实习生对补救过程的了解各不相同，他们对补救普遍表达了消极的想法和态度。97/132（73.5%）感到羞愧，71/132（53.8%）觉得处于不利地位，121/132（91.7%）对“补救”一词持负面看法。大多数实习生认为使用更积极的术语会改善看法，124/132（93.9%）觉得住院医师应参与制定个性化的补救计划。关于被安排接受补救的反应的开放式回答包括失望、羞愧、无能力、焦虑和担忧、尴尬、不开心、自杀倾向、毫无价值、失败感以及怀疑自己作为医生的能力。
实习生对补救的了解和理解有限，对补救过程有强烈的负面看法和态度。实习生建议，用更积极的术语重新表述补救，并让住院医师参与制定个性化计划，可能会改善对这一过程的态度和看法。
