实施近距离同伴支持计划,以改善患者安全事件后受训者的健康状况

IF 1.7 Q3 CRITICAL CARE MEDICINE ATS scholar Pub Date : 2023-09-06 eCollection Date: 2023-12-01 DOI:10.34197/ats-scholar.2023-0011PS
Kevin P Seitz, Nikita V Baclig, Robin Stiller, Anders Chen
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引用次数: 0

摘要

不良事件会对医生造成情绪上的伤害,如果不加以处理,可能会对健康产生负面影响,包括职业倦怠和抑郁。同伴支持有助于减轻这些负面影响。有组织的计划培训医生帮助同事处理与工作相关的经历和情绪,如内疚和自我怀疑。虽然此类计划对教职员工很常见,但对住院医师的同伴支持尚未得到充分关注,文献中描述的计划也很少。住院医生是职业身份形成的脆弱时期,提供支持具有特殊的挑战性。权力动态和生活经历之间的距离限制了教员同伴支持计划的效用。一些机构已经培训住院医师提供同伴支持,但由于住院医师的时间有限,在提供支持时也不太适应,因此很难广泛实施。然而,住院总医师(CR)与正在接受培训的住院医师关系密切,但经验丰富,能够提供独到的视角,在提供 "近似同伴 "支持方面具有得天独厚的优势。我们介绍了住院总医师近距离同伴支持计划的实施情况,在该计划中,我们对已有的同伴支持框架进行了调整,增加了针对住院医师压力和住院总医师与住院医师关系的具体内容。一名教职员工和两名即将离任的住院医师将主持一个 2 小时的工作坊,并将其纳入现有的住院医师入职培训中,以确保工作坊的可持续性。工作坊结合了大组说教和小组分组讨论,使用临床小故事和模拟近距离同伴支持对话。迄今为止,已有 36 名 CR 接受了培训。对于无法提供真正的住院医师同伴支持的项目来说,住院医师近同伴支持可以作为一种模式。
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Implementation of a Near-Peer Support Program to Improve Trainee Well-Being after Patient Safety Events.

Adverse events can take an emotional toll on physicians, which, left unprocessed, can have negative impacts on well-being, including burnout and depression. Peer support can help mitigate these negative effects. Structured programs train physicians to aid colleagues in processing work-related experiences and emotions such as guilt and self-doubt. Although such programs are common for faculty, peer support for resident physicians has not been adequately addressed, and few programs have been described in the literature. Residency is a vulnerable time of professional identity formation, and providing support has specific challenges. The power dynamics and distance between lived experiences limit the utility of faculty peer support programs. Some institutions have trained residents to provide peer support, but widespread implementation may be difficult because of limited resident time and comfort in providing support. Chief residents (CRs), however, are close to residents in training yet experienced enough to afford perspective and are uniquely situated to provide "near-peer" support. We describe the implementation of a CR near-peer support program in which an established peer support framework was adapted to add elements specific to resident stressors and CR-resident relationships. One faculty member and two outgoing CRs lead a 2-hour workshop that is built into existing CR onboarding to ensure sustainability. The workshop combines large-group didactics and small-group breakouts, using clinical vignettes and simulated near-peer support conversations. To date, 36 CRs have been trained. CR near-peer support can serve as a model for programs in which true resident peer support is not feasible.

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