Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Division of Clinical Pharmacology and Toxicology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Toong Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand.
BMC Med Educ. 2024 Sep 30;24(1):1076. doi: 10.1186/s12909-024-06011-y.
Grit refers to a combination of perseverance and passion, which is essential for long-term success. Grit is associated with higher education attainment and a lower likelihood of burnout. Understanding how grit evolves during internal medicine residency training is important for providing better support to residents. The primary objective of the current study was to evaluate potential changes in the level of grit throughout the training program and investigate the association between grit and stress levels, quality of life (QoL), and satisfaction of learning scores.
We conducted a prospective study involving internal medicine residents enrolled in training programs from July 2022 to July 2023, except for the second-third-year residents of dermatology and neurology programs and the third-year residents of haematology and oncology programs, which are not part of the same training regimen. Data collection was conducted using questionnaires at the beginning of the training year and every three months until the end. Collected data included age, gender, habitat, working experience, financial burden, marital status, rotations, grit scores, QoL, stress score, and satisfaction of learning score during each trimester. Changes in grit over the year were examined using repeated measures analysis of variance adjusted by training program, financial status, working experience, habitat, marital status, and age. We performed multivariable linear regression models to explore associations between grit and the following domains: QoL, ST-5, and SoLs.
Of 122 internal medicine residents in all three years of training, one resident dropped out during training, and another declined to participate. A total of 120 residents were included. Grit did not significantly change over time. Subgroup analysis of the first-year resident group revealed that grit significantly decreased (P = 0.049). Multivariable analysis revealed that grit was positively associated with QoL (β = 0.01, P < 0.001) and satisfaction of learning score (β = 0.07, P < 0.001) but inversely associated with stress score (β = - 0.04, P < 0.001).
Of all residents, grit did not change over a year. However, only the first-year residents reported a decrease in grit during a training year. Throughout first-year residents' internal medicine residency training, grit was positively associated with QoL and satisfaction of learning score but negatively associated with stress level. These findings suggest the need for targeted interventions to support first-year residents and enhance their resilience throughout training.
坚韧是指毅力和激情的结合，这对于长期成功至关重要。坚韧与更高的教育程度和更低的倦怠风险相关。了解坚韧在内科住院医师培训期间的发展变化对于为住院医师提供更好的支持非常重要。本研究的主要目的是评估培训计划期间坚韧水平的潜在变化，并探讨坚韧与压力水平、生活质量 (QoL) 和学习满意度评分之间的关联。
我们进行了一项前瞻性研究，涉及 2022 年 7 月至 2023 年 7 月期间参加培训计划的内科住院医师，但不包括皮肤科和神经病学计划的第二年至第三年住院医师以及血液学和肿瘤学计划的第三年住院医师，因为它们不属于同一培训方案。使用问卷在培训年度开始时和每三个月收集一次数据，直到结束。收集的数据包括年龄、性别、居住地、工作经验、经济负担、婚姻状况、轮转、坚韧评分、QoL、压力评分和每个三学期的学习满意度评分。使用重复测量方差分析调整培训计划、财务状况、工作经验、居住地、婚姻状况和年龄来检查一年中坚韧的变化。我们进行了多变量线性回归模型，以探讨坚韧与以下领域之间的关联：QoL、ST-5 和 SoLs。
在所有三年培训的 122 名内科住院医师中，一名住院医师在培训期间退出，另一名拒绝参加。共有 120 名住院医师入组。坚韧在时间上没有显著变化。第一年住院医师组的亚组分析显示，坚韧显著下降（P=0.049）。多变量分析显示，坚韧与 QoL（β=0.01，P<0.001）和学习满意度评分（β=0.07，P<0.001）呈正相关，但与压力评分（β=−0.04，P<0.001）呈负相关。
在所有住院医师中，一年中坚韧没有变化。然而，只有第一年住院医师在培训年度报告了坚韧的下降。在第一年住院医师的内科住院医师培训期间，坚韧与 QoL 和学习满意度评分呈正相关，但与压力水平呈负相关。这些发现表明需要采取有针对性的干预措施来支持第一年住院医师，并在整个培训期间增强他们的适应能力。
