Department of Family Medicine, University of Calgary, Alberta, Canada.
Can Med Educ J. 2023 Jun 27;14(3):143-151. doi: 10.36834/cmej.75312. eCollection 2023 Jun.
Learner distress is a huge problem in medicine today, and medical institutions have been called upon to help solve this issue. Unfortunately, the majority have responded not by addressing the system and culture that have long plagued the profession, but by creating individual-focused "wellness" interventions (IFWs). As a result, medical learners are routinely being forced to undergo training on resilience, mindfulness, and burnout.
Grounded in well-supported theory and empirical evidence, my central argument in this commentary is that IFWs are inappropriate, insulting, and psychologically harmful to learners, and that they need to stop.
Extending prior work in this area, I first present three fundamental problems with IFWs. I then recommend a paradigm shift in how we are approaching "wellness" in medical education.
Finally, I provide an evidence-based roadmap, in self-determination theory, for how system-level improvements could be made in a timely, sustainable, and socially responsible way, that would benefit everyone in medicine-from leaders, to educators, to learners, to patients.
在当今的医学领域，学习者的困扰是一个巨大的问题，医疗机构被要求帮助解决这个问题。不幸的是，大多数机构并没有通过解决长期困扰该行业的制度和文化问题来回应，而是采取了以个体为中心的“健康”干预措施（IFWs）。因此，医学学习者经常被迫接受关于韧性、正念和倦怠的培训。
本文的核心论点是基于充分支持的理论和实证证据，认为 IFWs 对学习者来说是不适当的、侮辱性的和心理上有害的，必须停止。
在该领域的先前工作的基础上，我首先提出了 IFWs 的三个基本问题。然后，我建议在医学教育中如何改变我们对待“健康”的方式。
最后，我根据自我决定理论提供了一个循证的路线图，说明如何以及时、可持续和负责任的方式在系统层面上进行改进，使医学领域的每个人都受益——从领导者、教育者到学习者再到患者。
