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一项四领域健康促进课程对内科住院医师的影响。

The Impact of a 4-Domain Wellness-Initiative Curriculum on Internal Medicine Resident Physicians.

作者信息

Vallabhaneni Esha, Cubeddu Luigi, Petit Ryan, Poli Fernando, Patel Premal, Rivera Cynthia

机构信息

Mount Sinai Medical Center, Miami Beach, FL.

Nova Southeastern University, College of Pharmacy, Davie, FL.

出版信息

HCA Healthc J Med. 2024 Jun 1;5(3):353-361. doi: 10.36518/2689-0216.1779. eCollection 2024.

Abstract

BACKGROUND

There is a trend toward fostering well-being, or the state of being happy and healthy, within the medical community. Historically, resident physicians have faced high rates of distress during training. A structured well-being curriculum in residency programs may shift residents' mindsets from survival and resilience to one centered on purpose, engagement, and joy.

METHODS

An original well-being curriculum was administered to residents in person at a single institution every 5 weeks for approximately 10 well-being workshops, totaling around 20 hours of curriculum exposure during every academic year. The well-being curriculum was divided into 4 domains: cognitive distortions and problematic mindsets, mindfulness and meditation, creative outlets, and self-compassion.Residents exposed to at least 1 year of the well-being curriculum were asked to answer an anonymous survey. Four questions were asked for each of the 4 domains. The first and second questions asked how familiar they were with the topic before and after the workshops on a scale of 1-5 of familiarity. The third and fourth questions asked how much the knowledge acquired influenced their professional and personal life on a scale of 1-5 of influence.

RESULTS

Before curriculum exposure, the average for moderate or higher levels of knowledge across all domains was 22.7%, which improved to 77.3% after curriculum completion. Overall, 58.6% of participants felt the knowledge of the domains was moderately or extremely influential in their professional lives and 83.6% in their personal lives. There were no significant differences between post-graduate year 2 and post-graduate year 3 residents for any domains examined before and after the wellness workshops.

CONCLUSION

A 4-domain well-being curriculum practiced in a group setting positively impacted participating residents in their personal and professional lives. Further studies need to be performed on a larger scale to assess if the curriculum fits the needs of the broader medical community.

摘要

背景

在医学界,有一种促进幸福安康(即快乐与健康的状态)的趋势。从历史上看,住院医师在培训期间面临着较高的压力。住院医师培训项目中的结构化幸福安康课程可能会将住院医师的思维模式从求生和适应力转变为以目标、参与和快乐为中心的思维模式。

方法

在一个机构中,每5周为住院医师亲自实施一次原创的幸福安康课程,共约10次幸福安康工作坊,每个学年的课程接触时间总计约20小时。幸福安康课程分为4个领域:认知扭曲和问题思维模式、正念与冥想、创造性表达途径以及自我同情。接触至少1年幸福安康课程的住院医师被要求回答一份匿名调查问卷。针对4个领域中的每个领域提出4个问题。第一个和第二个问题询问他们在工作坊前后对该主题的熟悉程度,熟悉程度从1至5分进行评分。第三个和第四个问题询问所获得的知识在多大程度上影响了他们的职业和个人生活,影响程度从1至5分进行评分。

结果

在接触课程之前,所有领域中知识水平达到中等或更高水平的平均比例为22.7%,课程结束后提高到了77.3%。总体而言,58.6%的参与者认为这些领域的知识对他们的职业生活有中等或极大影响,83.6%的参与者认为对他们的个人生活有中等或极大影响。在幸福安康工作坊前后,对于所考察的任何领域,二年级和三年级住院医师之间均无显著差异。

结论

在小组环境中实施的4领域幸福安康课程对参与的住院医师的个人和职业生活产生了积极影响。需要进行更大规模的进一步研究,以评估该课程是否符合更广泛医学界的需求。

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本文引用的文献

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Contemplative medicine: A practical approach to "Well-Being 2.0" in medicine.静观医学:医学中“健康 2.0”的实用方法。
Explore (NY). 2024 May-Jun;20(3):439-442. doi: 10.1016/j.explore.2023.11.002. Epub 2023 Nov 10.
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What Is Wellbeing?什么是幸福?
Int J Environ Res Public Health. 2023 Mar 12;20(6):5006. doi: 10.3390/ijerph20065006.
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Self-Compassion: Theory, Method, Research, and Intervention.自我同情:理论、方法、研究与干预
Annu Rev Psychol. 2023 Jan 18;74:193-218. doi: 10.1146/annurev-psych-032420-031047. Epub 2022 Aug 12.
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Small-Group Discussion Sessions on Imposter Syndrome.小组讨论:冒名顶替综合征
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Wellness and Work: Mixed Messages in Residency Training.工作与健康:住院医师培训中的复杂信息。
J Gen Intern Med. 2019 Jul;34(7):1352-1355. doi: 10.1007/s11606-019-04952-5.

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