Marr Mollie C, Patel Karishma, Harrison Rebecca A
Department of Psychiatry, Massachusetts General Hospital, Boston, MA USA.
Department of Psychiatry, McLean Hospital, Belmont, MA USA.
Discov Health Syst. 2025;4(1):68. doi: 10.1007/s44250-025-00241-7. Epub 2025 Jun 5.
This study investigated the necessity of culture change in clinical care and medical education within a US academic hospital before and during the COVID-19 pandemic. It explored how the syndemics of COVID-19, racism, and the mental health crisis magnified the urgency of culture change in healthcare and aimed to understand the impact of these syndemics on healthcare and educational culture.
An 11-item survey with 8 open-ended questions was distributed to healthcare teams and trainees at a large academic medical center before (Dec 2019 to March 2020) and during the pandemic (Feb 2021 to April 2021). The survey examined need for culture change, where it has worked well, and factors contributing to successful culture change. Responses were analyzed and themes were generated by qualitative analysis.
The study revealed a strong focus on person-centered care before the pandemic with an emphasis on interdisciplinary care, communication, and safety. Within the pandemic, the focus shifted to COVID-19 safety, increased staffing and support, addressing health disparities and racism in healthcare, and use of telemedicine. As the pandemic evolved, burnout and mental health concerns became more prominent raising questions about the sustainability of culture changes..
The study highlighted cultural shifts within healthcare and medical education magnified by syndemics. There is a growing emphasis on anti-racism, respect, and psychological safety. It emphasized the importance of understanding cultural shifts within institutions to drive effective culture change. Future research should explore different healthcare settings and post-pandemic culture changes. This study provided valuable insight into the landscape of culture change, clinical care, and education, especially in response to COVID-19 pandemic challenges.
The online version contains supplementary material available at 10.1007/s44250-025-00241-7.
本研究调查了美国一家学术医院在新冠疫情之前及期间临床护理和医学教育中文化变革的必要性。它探讨了新冠疫情、种族主义和心理健康危机的综合征如何加剧了医疗保健领域文化变革的紧迫性，并旨在了解这些综合征对医疗保健和教育文化的影响。
在一家大型学术医疗中心，于疫情之前（2019年12月至2020年3月）和疫情期间（2021年2月至2021年4月），向医疗团队和实习生发放了一份包含8个开放式问题的11项调查问卷。该调查考察了文化变革的需求、变革成效良好的方面以及促成成功文化变革的因素。对回复进行了分析，并通过定性分析得出了主题。
研究表明，在疫情之前，重点强烈放在以患者为中心的护理上，强调跨学科护理、沟通和安全。在疫情期间，重点转向了新冠疫情安全、增加人员配备和支持、解决医疗保健中的健康差距和种族主义问题以及远程医疗的使用。随着疫情的发展，职业倦怠和心理健康问题变得更加突出，引发了关于文化变革可持续性的问题。
该研究突出了由综合征放大的医疗保健和医学教育中的文化转变。人们越来越强调反种族主义、尊重和心理安全。它强调了理解机构内部文化转变以推动有效文化变革的重要性。未来的研究应探索不同的医疗保健环境和疫情后文化变革。本研究为文化变革、临床护理和教育的格局提供了宝贵的见解，尤其是应对新冠疫情挑战方面。
在线版本包含可在10.1007/s44250-025-00241-7获取的补充材料。
