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医疗保健学习者的“二次受害者”经历以及培训环境对事件后适应的影响。

Second Victim Experiences of Health Care Learners and the Influence of the Training Environment on Postevent Adaptation.

作者信息

Huang Lily, Riggan Kirsten A, Torbenson Vanessa E, Osborne Alayna K, Chesak Sherry S, Finney Robyn E, Allyse Megan A, Rivera-Chiauzzi Enid Y

机构信息

Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL.

Biomedical Ethics Research Program, Mayo, q1Clinic, Rochester, MN.

出版信息

Mayo Clin Proc Innov Qual Outcomes. 2024 Apr 24;8(3):232-240. doi: 10.1016/j.mayocpiqo.2024.03.004. eCollection 2024 Jun.

Abstract

OBJECTIVE

To investigate the experience of medical and graduate learners with second victim experience (SVE) after medical errors or adverse patient outcomes, including impact on training and identification of factors that shape their postevent recovery.

PATIENTS AND METHODS

The validated Second Victim Experience and Support Tool-Revised (SVEST-R), Physician Well-Being Index, and supplemental open-ended questions were administered to multidisciplinary health care learners between April 8, 2022, and May 30, 2022, across a large academic health institution. Open-ended responses were qualitatively analyzed for iterative themes related to impact of SVE on the training experience.

RESULTS

Of the 206 survey respondents, 144 answered at least 1 open-ended question, with 62.1% (n=91) reporting at least 1 SVE. Participants discussed a wide range of SVEs and indicated that their postevent response was influenced by their training environment. Lack of support from supervisors and staff exacerbated high stress situations. Some trainees felt blamed and unsupported after a traumatic experience. Others emphasized that positive training experiences and supportive supervisors helped them grow and regain confidence. Learners described postevent processing strategies helpful to their recovery. Some, however, felt disincentivized from seeking support.

CONCLUSION

This multidisciplinary study of learners found that the training environment was influential in postevent recovery. Our findings support the need for the inclusion of education on SVEs and adaptive coping mechanisms as part of health care professional educational curriculums. Educators and health care staff may benefit from enhanced education on best practices to support trainees after stressful or traumatic patient events.

摘要

目的

调查医学专业学生和研究生在发生医疗差错或不良患者结局后经历二次受害者体验(SVE)的情况,包括对培训的影响以及确定影响他们事件后恢复的因素。

患者与方法

在2022年4月8日至2022年5月30日期间,对一家大型学术健康机构的多学科医疗保健学习者使用经过验证的《二次受害者体验与支持工具修订版》(SVEST-R)、《医生幸福感指数》以及补充性开放式问题进行调查。对开放式回答进行定性分析,以找出与SVE对培训体验的影响相关的反复出现的主题。

结果

在206名调查受访者中,144人回答了至少1个开放式问题,其中62.1%(n=91)报告至少经历过1次SVE。参与者讨论了各种各样的SVE,并表示他们事件后的反应受到培训环境的影响。主管和工作人员缺乏支持加剧了高压力情况。一些受训人员在经历创伤性事件后感到受到指责且得不到支持。其他人则强调积极的培训经历和支持性的主管帮助他们成长并重新获得信心。学习者描述了有助于他们恢复的事件后处理策略。然而,一些人觉得寻求支持没有动力。

结论

这项针对学习者的多学科研究发现,培训环境对事件后的恢复有影响。我们的研究结果支持将关于SVE和适应性应对机制的教育纳入医疗保健专业教育课程的必要性。教育工作者和医护人员可能会从加强关于在压力或创伤性患者事件后支持受训人员的最佳实践的教育中受益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97de/11068502/ae2ddfcb2792/gr1.jpg

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