Boitet Laurence M, Rogers David A, Sweeney Katherine L, Schall Mark C, Gorman C Allen, Jones Bobby
Department of Medical Education, University of Alabama at Birmingham, Birmingham, AL.
UAB Medicine Office of Wellness, University of Alabama at Birmingham, Birmingham, AL.
Mayo Clin Proc Innov Qual Outcomes. 2025 Mar 19;9(2):100601. doi: 10.1016/j.mayocpiqo.2025.100601. eCollection 2025 Apr.
To examine the experience of clinical and research trainees within an academic medical center setting to identify and compare factors influencing their wellbeing.
A cross-sectional, anonymous survey was conducted from June to July 2022 at a large academic medical center. Responses from clinical and research trainees were analyzed for this study. The survey assessed participant wellbeing using the Well-Being Index (WBI), in addition to perceptions of individual and organizational factors. Data were analyzed to identify correlates of elevated WBI scores and differences in clinical and research experience.
Ordinal logistic regression analysis identified low sense of recognition (odds ratio [OR], 0.59; 95% CI, 0.44-0.79), low role clarity (OR, 0.58; 95% CI, 0.42-0.80), moral distress (OR, 1.61; 95% CI, 1.24-2.10), and social isolation or loneliness (OR, 2.79; 95% CI 1.69-4.61) as significantly associated with high WBI scores, accounting for 48.8% of predicted variance. Additionally, distressed clinical trainees (WBI≥2) reported lower control over their work (<.001) and significantly higher perceived stress from heavy workload (.05) and long hours (<.01), compared with distressed research trainees. Distressed research trainees reported lower levels of trust in their supervisor (<0.01), lower perceived organizational support (<.05), and lower role clarity (<.05), compared with distressed medical trainees. Low recognition, moral distress, and perceived stress from social isolation and loneliness were experienced similarly between groups.
Our study indicates that trainees experience high levels of distress, although the sources differ. To effectively address these challenges, organizations should implement interventions targeted to address specific stressors of each group.
考察学术医疗中心环境下临床和研究学员的经历，以识别和比较影响他们幸福感的因素。
2022年6月至7月在一家大型学术医疗中心进行了一项横断面匿名调查。本研究分析了临床和研究学员的回复。该调查除了评估个人和组织因素的认知外，还使用幸福感指数（WBI）评估参与者的幸福感。对数据进行分析，以确定WBI得分升高的相关因素以及临床和研究经历的差异。
有序逻辑回归分析确定，认可度低（优势比[OR]，0.59；95%置信区间[CI]，0.44 - 0.79）、角色清晰度低（OR，0.58；95% CI，0.42 - 0.80）、道德困扰（OR，1.61；95% CI，1.24 - 2.10）以及社会孤立或孤独感（OR，2.79；95% CI 1.69 - 4.61）与高WBI得分显著相关，占预测方差的48.8%。此外，与感到困扰的研究学员相比，感到困扰的临床学员（WBI≥2）报告对工作的控制感较低（<.001），并且因工作量大（.05）和工作时间长（<.01）而感受到的压力明显更高。与感到困扰的医学学员相比，感到困扰的研究学员报告对上级的信任度较低（<0.0l）、感知到的组织支持较低（<.05）以及角色清晰度较低（<.05）。两组在认可度低、道德困扰以及社会孤立和孤独感带来的感知压力方面体验相似。
我们的研究表明，学员们经历着高水平的困扰，尽管其来源有所不同。为了有效应对这些挑战，各机构应实施针对性干预措施，以解决每组学员的特定压力源。
