英国外科住院医师强化应激适应力培训：效果与进展评估
Enhanced Stress Resilience Training for UK Surgical Trainees; Effect and Evolution Evaluated.
作者信息
Luton Oliver W, James Osian P, Mellor Katie, Eley Catherine, Hopkins Luke, Robinson David B T, Barlow Emma, Lebares Carter C, Lewis Wyn G, Egan Richard J
机构信息
Department of General Surgery, NHS Wales Health Education and Improvement Wales' School of Surgery, Tŷ Dysgu, Cefn Coed, Nantgarw, United Kingdom.
Department of General Surgery, NHS Wales Health Education and Improvement Wales' School of Surgery, Tŷ Dysgu, Cefn Coed, Nantgarw, United Kingdom; Department of General Surgery, Cardiff University School of Medicine, Heath Park, Cardiff, United Kingdom.
出版信息
J Surg Educ. 2023 Oct;80(10):1395-1402. doi: 10.1016/j.jsurg.2023.07.017. Epub 2023 Aug 9.
INTRODUCTION
Core Surgical Training (CST) programs are associated with high burnout. This study aimed to assess the influence of Enhanced Stress Resilience Training (ESRT) over a 2-year period in a single UK Statutory Education Body.
METHOD
CSTs participated in 5-weeks of formal ESRT to address work stressors. The primary outcome measure was career progression related to curriculum metrics and National Training Number (NTN) appointment. Secondary measures related to burnout using validated psychological inventories.
RESULTS
Of 42 CSTs, 13 engaged fully with ESRT (31.0%; male 8, female 5, median age 28 year.), 11 engaged partially, and 18 did not. ESRT engagement was associated with better NTN appointment (ESRT 8/13 (61.5%) vs. not 1/18 (5.6%), p = 0.025), less burnout [aMBI; mean 5.14 (SD ± 2.35) vs. 3.14 (±2.25), F 6.637, p = 0.002, η=0.167], less stress [PSS-10; 19.22 (±5.91) vs. 15.79 (±5.47), F 8.740, p < 0.001, η=0.200], but more mindfulness [CAMS-R; 19.22 (±5.91) vs. 20.57 (±2.93), F 3.201, p = 0.047, η=0.084]. On multivariable analysis, Improving Surgical Training (run-through CST) program (OR 5.2 (95% CI 1.42-28.41, p = 0.022), MRCS pass (OR 17.128 (95% CI 1.48-197.11, p = 0.023) and ESRT engagement (OR 13.249, 95% CI 2.08-84.58, p = 0.006) were independently associated with NTN success.
DISCUSSION
ESRT was associated with less stress and burnout, better mindfulness, and most importantly 13-fold better career progression.
引言
核心外科培训（CST）项目与高职业倦怠率相关。本研究旨在评估在英国一个法定教育机构中，为期两年的强化压力恢复力培训（ESRT）的影响。
方法
CST参与者参加了为期5周的正式ESRT，以应对工作压力源。主要结局指标是与课程指标和国家培训编号（NTN）任命相关的职业发展。次要指标是使用经过验证的心理量表来评估职业倦怠。
结果
在42名CST中，13人完全参与了ESRT（31.0%；男性8人，女性5人，中位年龄28岁），11人部分参与，18人未参与。参与ESRT与更好的NTN任命相关（参与ESRT者8/13（61.5%），未参与者1/18（5.6%），p = 0.025），职业倦怠更少[阿姆斯特丹倦怠量表；均值5.14（标准差±2.35）对3.14（±2.25），F = 6.637，p = 0.002，η = 0.167]，压力更小[感知压力量表-10；19.22（±5.91）对15.79（±5.47），F = 8.740，p < 0.001，η = 0.200]，但正念更多[康奈尔医学指数-修订版；19.22（±5.91）对20.57（±2.93），F = 3.201，p = 0.047，η = 0.084]。在多变量分析中，改进外科培训（直通式CST）项目（比值比5.2（95%置信区间1.42 - 28.41，p = 0.022））、皇家外科学院会员考试通过（比值比17.128（95%置信区间1.48 - 197.11，p = 0.023））和参与ESRT（比值比13.249，95%置信区间2.08 - 84.58，p = 0.006）与NTN成功独立相关。
讨论
ESRT与更低的压力和职业倦怠、更好的正念相关，最重要的是，职业发展提升了13倍。
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