UCSF Center of Mindfulness in Surgery, Department of Surgery, University of California San Francisco, San Francisco, California.
UCSF Center of Mindfulness in Surgery, Department of Surgery, University of California San Francisco, San Francisco, California.
J Surg Educ. 2024 Apr;81(4):514-524. doi: 10.1016/j.jsurg.2023.12.010. Epub 2024 Feb 22.
Workplace interventions that increase support can mitigate burnout, improve workplace satisfaction, and increase well-being. Our aim is to provide evidence-based targets to inform future work for operationalizing support in general surgery residency.
This is a 2-part mixed-methods cross-sectional study. Part 1 analyzed qualitative data from focus groups (April 2021-May 2022). Part 2 comprised an online survey (informed by findings in Part 1) in May 2022 to assess the association between perceived psychological safety (PS) and flourishing, as well as PS and languishing.
National multi-center study including 16 ACGME-accredited academic programs.
General surgery residents at various training levels, in both clinical and research.
A total of 28 residents participated in the focus groups which revealed both enhancers and inhibitors of support pertaining to PS in the workplace. Enhancers of support included those currently implemented (i.e., allyship of mentors) and those proposed by residents (i.e., nonpunitive analysis of mistakes). Inhibitors of support included both systems (i.e., wellness initiatives as a 'band-aid' for systems issues) and culture (i.e., indefatigability, stoicism). About 251 residents (31%) responded to the survey which revealed higher perception of PS was significantly associated with flourishing at the level of residency program and departmental leadership. Lower perception of PS was significantly associated with languishing at the level of residency program leadership only.
Our findings highlight the promotion of PS, such as expansion of mentorship to include advocacy (advocating on a resident's behalf, recognition when mistreated) and affirmation (i.e., soliciting opinions on controversial social matters/events, recognizing different life experiences), cultural acceptance of asking for help (without being perceived as weak), formal help navigating interpersonal dynamics (i.e., guidance from senior residents), and leadership presentations and modeling to destigmatize asking for help, as a means of operationalizing workplace support to increase flourishing and decrease languishing.
增加支持的工作场所干预措施可以减轻倦怠，提高工作场所满意度，并提高幸福感。我们的目标是提供循证目标，为普通外科住院医师培训中的支持提供信息。
这是一项 2 部分混合方法横断面研究。第 1 部分分析了 2021 年 4 月至 2022 年 5 月焦点小组的定性数据。第 2 部分是 2022 年 5 月进行的在线调查（根据第 1 部分的结果），以评估感知心理安全（PS）与繁荣以及 PS 与萎靡不振之间的关联。
包括 16 个 ACGME 认证的学术项目的全国多中心研究。
处于不同培训水平的普通外科住院医师，包括临床和研究人员。
共有 28 名住院医师参加了焦点小组，这些小组揭示了工作场所 PS 支持的增强因素和抑制因素。支持的增强因素包括目前实施的因素（即导师的盟友关系）和住院医师提出的因素（即对错误进行非惩罚性分析）。支持的抑制因素包括系统（即，作为系统问题的“创可贴”的健康计划）和文化（即，不知疲倦，坚忍不拔）。大约 251 名（31%）住院医师对调查做出了回应，结果表明，更高的 PS 感知与住院医师计划和部门领导层面的繁荣显着相关。PS 感知度较低与住院医师计划领导层的萎靡不振显着相关。
我们的研究结果强调了促进 PS 的重要性，例如扩大指导范围，包括倡导（代表住院医师进行倡导，在受到虐待时得到认可）和肯定（即，就有争议的社会问题/事件征求意见，承认不同的生活经历），接受寻求帮助的文化（即，不被视为软弱），正式帮助处理人际关系动态（即，寻求资深住院医师的指导），以及领导的演讲和示范，以消除寻求帮助的污名化，以此作为增加繁荣和减少萎靡不振的工作场所支持的实施手段。
