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自主性与独立性:对住院医师和教员参与度、表现及幸福感的影响

Autonomy Versus Independence: Implications for Resident and Faculty Engagement, Performance, and Well-Being.

作者信息

Neufeld Adam P, Rigby C Scott

机构信息

University of Calgary, Cumming School of Medicine, Calgary, Canada.

Founder/CEO of motivationWorks, Celebration FL.

出版信息

HCA Healthc J Med. 2024 Jun 1;5(3):209-213. doi: 10.36518/2689-0216.1780. eCollection 2024.

Abstract

Description Research shows that when educational leaders support their learners' autonomy, it positively impacts both parties. This is particularly important in graduate medical education (GME), given that there is a strong emphasis on resident performance, evaluation, and development. Unfortunately, GME faculty often misunderstand autonomy as the resident's desire for independence or "freedom," when in fact it refers to the core psychological need to feel volitional and agentic. The distinction is important because volition is not synonymous with independence, and providing freedom can be at odds with strategies that provide true autonomy support. This, in turn, can contribute to the stress, maladjustment, and resident burnout that are already prevalent in medicine. To help remedy this issue, this paper provides an evidence-based guide for medical educators to distinguish autonomy from independence, with specific examples to help translate theory into practice to better support the well-being of the medical community.

摘要

描述 研究表明,当教育领导者支持学习者的自主性时,这对双方都有积极影响。鉴于研究生医学教育(GME)非常强调住院医师的表现、评估和发展,这一点在GME中尤为重要。不幸的是,GME教员常常将自主性误解为住院医师对独立或“自由”的渴望,而实际上它指的是一种核心心理需求,即感觉有意志和能动性。这种区别很重要,因为意志并不等同于独立,提供自由可能与提供真正自主性支持的策略相悖。反过来,这可能会导致医学领域中已经普遍存在的压力、适应不良和住院医师倦怠。为了帮助解决这个问题,本文为医学教育工作者提供了一个基于证据的指南,以区分自主性和独立性,并给出具体例子,帮助将理论转化为实践,以更好地支持医学界的福祉。

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