Clinical Pediatrics (T Bamat), Perelman School of Medicine at the University of Pennsylvania, Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Pediatric Critical Care Medicine (A Gula), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Acad Pediatr. 2024 Aug;24(6):883-888. doi: 10.1016/j.acap.2024.04.001. Epub 2024 Apr 10.
Workplace mistreatment is a contributor to resident burnout; understanding and intervening against mistreatment is one key tool in mitigating burnout. While Accreditation Council for Graduate Medical Education (ACGME) survey data alerts programs to general mistreatment trends, those data are not detailed enough to inform local interventions. Our team designed and implemented a Challenging Interactions Reporting Tool (CIRT) to characterize the experiences of our trainees at a granular level and to inform targeted interventions for improvement.
Our CIRT was offered to 158 residents in August 2020 via REDCap. Residents submit electronic reports that are reviewed weekly by program leaders who develop action plans for each report. Reporters can identify themselves or can choose to remain anonymous. When "hot spots" for mistreatment are identified in our hospital, we implement a targeted systems-level intervention.
Residents filed 275 reports between August 2020 and December 2022. Reports represented all training environments and involved all interprofessional members of clinical teams. Residents reported awareness of, use of, and satisfaction with the tool.
Our program created the CIRT as a tool to inform local interventions for improving the safety of our clinical learning environment. We continue to disseminate our tool across our hospital's GME programs and are now measuring the impact of our interventions.
工作场所虐待是导致住院医师倦怠的一个因素；了解和干预虐待行为是减轻倦怠的一个关键工具。虽然研究生医学教育认证委员会 (ACGME) 的调查数据提醒项目注意普遍的虐待趋势，但这些数据还不够详细，无法为当地干预措施提供信息。我们的团队设计并实施了具有挑战性的互动报告工具 (CIRT)，以更详细地了解我们学员的经历，并为改进提供有针对性的干预措施。
我们的 CIRT 于 2020 年 8 月通过 REDCap 提供给 158 名住院医师。住院医师提交电子报告，项目负责人每周审查这些报告，并为每份报告制定行动计划。报告人可以选择实名或匿名。当我们医院发现虐待的“热点”时，我们会实施有针对性的系统干预措施。
2020 年 8 月至 2022 年 12 月期间，住院医师提交了 275 份报告。报告涵盖了所有培训环境，并涉及临床团队的所有专业人员。住院医师表示了解、使用并对该工具感到满意。
我们的项目创建了 CIRT，作为一种工具，为改善我们临床学习环境的安全性提供信息。我们继续在我们医院的 GME 项目中推广我们的工具，并正在衡量我们干预措施的效果。
