Factores psicosociales y sociodemográficos asociados con el desgaste profesional en médicos residentes de Sonora (México) / Psychosocial and Sociodemographic Factors Associated with Burnout among Medical Residents of Sonora ­ Mexico / Fatores psicossociais e sociodemográficos associados ao burnout em médicos residentes de Sonora, México

Introducción: la simultaneidad de actividades entre las exigencias académicas y el adiestramiento médico durante las residencias provoca un elevado riesgo de desarrollar un desgaste profesional (o síndrome de burnout [SB]) en los médicos residentes. El objetivo fue identificar los factores psicosociales y socio- demográficos asociados al SB en médicos residentes. Materiales y métodos: estudio transversal y correlacional. Participaron 47 médicos residentes de un hospital público. Se aplicaron la Escala de Desgaste Ocupacional (EDO), el Inventario Multifásico de la Personalidad Minnesota-2 Forma Reestructurada (MMPI2-Rf) y un cuestionario sociodemográfico. Los datos se analizaron mediante la prueba de correlación no paramétrica de Spearman. Resultados: el 25.6 % de los participantes mostró burnout alto, y el 51 %, un agotamiento emocional alto. Respecto a los factores de personalidad y sociodemográficos asociados, solo mostraron relación significativa (p < 0.05) la escala de impulsividad (r = 0.341, p = 0.019) y las horas de ejercicio en la semana (r = −0.414, p = 0.004). Al segmentar por sexo, solo en los hombres del estudio existió una relación entre SB y psicoticismo (r = 0.468, p = 0.018), la disminución de la actividad física (r = −0.620, p = 0.001) y primeros años de residencia (r = −0.396, p = 0.050). Conclusiones: el alto agotamiento emocional de los residentes está asociado con problemas en el manejo de impulsos, distorsiones de la realidad (debido al psicoticismo), pertenecer a los primeros años de residencia y falta de ejercicio físico. Se requiere especial atención a la salud física y mental de estos profesionales

Introduction: The simultaneity of activities between academic demands and medical training during residencies is a high risk of developing burnout syndrome (BS) among resident physicians, which decreases their quality of life. This study aimed to identify the psychosocial and sociodemographic factors associated with BS among resident physicians from a public hospital. Materials and methods: This cross-sectional and correlational study involved 47 resident physicians. The Occupational Burnout Scale (EDO), the Minnesota Multiphasic Personality Inventory-2 Restructured Form, and a sociodemographic questionnaire were applied. The data were analyzed by using nonparametric Spearman's correlation test. Results: We found that 25.6% of the participants had a high level of burnout, while 51% showed a high level of emotional exhaustion. Regarding personality and sociodemographic factors associated with BS, only the impulsivity scale (r = 0.341; p = 0.019) and the hours of exercise performed in a week (r = −0.414; p = 0.004) showed a significant relationship (p < 0.05). When segmented by sex, a relationship between BS and psychoticism (r = 0.468; p = 0.018), decreased physical activity (r = −0.620; p = 0.001), and first years of residence (r = −0.396; p = 0.050) were noted only in men. Conclusions: A high level of emotional exhaustion was evidenced among the medical residents in relation to the development of their activities, which were associated with problems in the management of impulses, distortions of reality (due to psychoticism), belonging to the first years of residency, and the lack of physical exercise. Hence, special attention must be given to the physical and mental health of medical residents

Introdução: a simultaneidade de atividades entre as demandas acadêmicas e ao mesmo tempo a formação médica durante as residências acarreta alto risco de desenvolvimento da Síndrome de Burnout (SB) nos médicos residentes, diminuindo sua qualidade de vida. O objetivo da pesquisa foi identificar os fatores psicossociais e sociodemográficos associados à SB em médicos residentes. Materiais e métodos: estudo transversal e correlacional. Participaram 47 médicos residentes de um hospital público. Aplicou-se a Escala de Desgaste Ocupacional (EDO), o Inventário Multifásico da Personalidade Minnesota-2 Forma Reestruturada (MMPI2-Rf) e adicionalmente um questionário sociodemográfico. Os dados foram analisados por meio do teste de correlação não paramétrica de Spearman. Resultados: 25,6% dos participantes apresentaram alto burnout e 51% alto nível de exaustão emocional. Em relação aos fatores de personalidade e sociodemográficos associados à SB, apenas a escala de impulsividade (r = 0,341; p = 0,019) e as horas de exercício por semana (r = −0,414; p = 0.004) apresentaram relação significativa (p < 0,05). Quando segmentado por sexo, apenas nos homens do estudo houve relação entre SB e psicoticismo (r = 0,468; p = 0,018), diminuição da atividade física (r = −0,620; p = 0,001) e primeiros anos de residência (r = −0,396; p = 0,050). Conclusões: destaca-se o elevado desgaste emocional vivenciado pelos residentes no desenvolvimento das suas atividades, que se associa a problemas na gestão dos impulsos, distorções da realidade (devido ao psicoticismo), estar nos primeiros anos de residência e falta de exercício físico. É necessária atenção especial à saúde física e mental desses profissionais

Aproximación hacia la evaluación de la aptitud clínica en residentes de cardiología. Diseño multicéntrico / Approach to cardiology residents clinical aptitude evaluation. Multicenter design

Resumen Introducción: Hasta donde se tiene conocimiento, la investigación que se presenta constituye el primer trabajo multicéntrico en México que estudia el desarrollo de la aptitud clínica en unidades formadoras de cardiólogos. Objetivo: Determinar el grado de desarrollo de la aptitud clínica en residentes de cardiología en tres unidades médicas de alta especialidad. Métodos: Diseño transversal multicéntrico. Se analizaron todos los estudiantes del ciclo académico 2019-2020. Se construyó un instrumento que evaluó la aptitud clínica a partir de ocho indicadores y 170 ítems; la validez conceptual/de contenido y la confiabilidad fueron valoradas por cinco cardiólogos con experiencia docente y en investigación educativa. Resultados: Por indicador y año de residencia se observaron diferencias estadísticas significativas en la sede CMN20Nov; en HCSXXI e INCICh se observaron diferencias estadísticamente significativas en uno de ocho indicadores. Se estimaron diferencias entre residentes R1 (n = 41) de las tres sedes por indicador, con significación estadística en tres de ocho indicadores. El resultado fue semejante al comparar R2 (n = 35) y R3 (n = 43). Conclusiones: El grado de desarrollo de la aptitud clínica se puede considerar medio en las tres sedes académicas, probablemente debido a que el instrumento exploró situaciones clínicas problematizadas que exigieron del residente la reflexión crítica de su experiencia clínica.

Abstract Introduction: To the best of our knowledge, the research herein presented is the first multicenter study in Mexico to analyze the development of clinical aptitude in medical units that train cardiologists. Objective: To determine the degree of development of clinical aptitude in cardiology residents at three High Specialty Medical Units. Methods: Multicenter, cross-sectional design. All students of the 2019-2020 academic year were included in the study. An instrument was constructed that evaluated clinical aptitude based on eight indicators and 170 items; conceptual/content validity and reliability were assessed by five cardiologists with teaching and educational research experience. Results: By indicator and year of residence, significant statistical differences were observed in the CMN20Nov academic site. At HCSXXI and INCICh, statistically significant differences were observed in one of eight indicators. Differences between R1 residents (n = 41) of all three academic sites were estimated by indicator, with statistical significance being recorded in three of eight indicators. Between R2 (n = 35) and between R3 residents (n = 43), the result was similar. Conclusions: The degree of clinical aptitude development can be considered intermediate in all three academic sites, probably because the instrument explored problematized clinical situations that required the residents to critically reflect on their clinical experience.

Evaluación del estado nutricional, los patrones de alimentación y realización de actividad física de los médicos residentes del Hospital General de Luque del año 2020

RESUMEN Los médicos residentes enfrentan cambios en el estilo de vida, adquisición de hábitos alimenticios inadecuados, influencia de modas, publicidad y necesidad de pertenecer a un grupo social, por lo cual se encuentran en riesgo de padecer sobrepeso y obesidad. Nuestro objetivo fue determinar el estado nutricional, los patrones de alimentación y la realización de actividad física de los médicos residentes del Hospital General de Luque del año 2019. Se realizó un estudio descriptivo, observacional de corte transversal en el que se evaluaron variables sociodemográficas, antropométricas, estado nutricional, patrón alimentario y actividad física. Se incluyó un total de 58 médicos residentes de los cuales 66% fueron del sexo femenino, y la edad promedio fue de 28,12 años. Según el IMC, la mayoría presentó sobrepeso (34,5%). En cuanto a los patrones de alimentación, la mayoría no cumplía con las recomendaciones de las Guías Alimentarias del Paraguay de consumir 3 frutas por día ni de evitar alimentos ricos en grasas, sodio y altos en calorías como lo son las comidas rápidas. Se observó que 49% no realizaba actividad física. Los médicos residentes del Hospital General de Luque presentaron en su mayoría exceso de peso, tenían un patrón alimentario inadecuado y no realizaban actividad física.

ABSTRACT Resident physicians face changes in lifestyle, acquisition of inappropriate eating habits, influence of fashions, advertising and the need to belong to a social group, which is why they are at risk of being overweight and obese. Our objective was to determine the nutritional status, eating patterns and physical activity of the resident doctors of the General Hospital of Luque in 2019. A descriptive, observational cross-sectional study was carried out in which sociodemographic variables, anthropometric, nutritional status, eating pattern and physical activity were evaluated. A total of 58 resident physicians were included, of which 66% was female, and the average age was 28.12 years. According to the BMI, the majority were overweight (34.5%). Regarding eating patterns, most did not comply with the recommendations of the Paraguayan Dietary Guidelines of consuming 3 fruits per day or avoiding foods rich in fat, sodium and high in calories such as fast foods. It was observed that 49% did not perform physical activity. The resident physicians of the General Hospital of Luque were mostly overweight, had an inadequate eating pattern and did not perform physical activity.

Burnout Syndrome: an analysis of the mental health of medical residents in a teaching hospital / Síndrome de Burnout: uma análise da saúde mental dos residentes médicos de um Hospital Escola

Abstract: Introduction: Medical residency can cause burnout syndrome, a physical, emotional and mental state of extreme exhaustion. Objective: This research sought to describe and analyze the prevalence of burnout in resident physicians linked to a teaching Hospital and to verify whether there is a correlation with sociodemographic and socioeconomic data. Method: This is an analytical, cross-sectional and quantitative study using the MBI (Malasch Burnout Inventory) version HSS (Human Services Survey), the Brazilian Economic Classification Criterion (CCEB) of ABEP and sociodemographic questions. Result: Of the enrolled residents, 102 participated in the survey. Of these, 76.47% showed a high level in at least one of the three domains of the burnout index and 21.57% of the residents showed a high level of burnout. There was a significant relationship between a larger number of children and the presence of emotional exhaustion (P=0.047), a higher frequency of depersonalization for surgical area residents (P=0.013) and reduced professional accomplishment, with an average income of R$ 2,965.69 and R$ 10,386.52 (P=0.006). No significant relationship was found between burnout and sociodemographic and socioeconomic variables. Conclusion: The results show that resident physicians are exposed to situations that contribute to high levels of stress and distress. Further studies on the subject are still necessary.

Resumo: Introdução: A residência médica pode causar a síndrome de burnout, um estado físico, emocional e mental de exaustão extrema. Objetivo: Buscou-se com esta pesquisa descrever e analisar a prevalência de burnout em médicos residentes vinculados a um hospital-escola e verificar se há correlação com dados sociodemográficos e socioeconômicos. Método: Este é um estudo analítico, transversal e quantitativo realizado por meio do Maslach Burnout Inventory (MBI) versão Human Services Survey (HSS), do Critério de Classificação Econômica Brasil (CCEB) da Abep e de perguntas sociodemográficas. Resultado: Dos 221 residentes matriculados, 102 participaram da pesquisa. Destes, 76,47% apresentaram alto nível em pelo menos um dos três domínios do índice de burnout e 21,57% dos residentes exibiram alto nível de burnout. Houve relação significativa entre maior número de filhos e presença de exaustão emocional (p = 0,047), maior frequência de despersonalização para residentes da área cirúrgica (p = 0,013) e reduzida realização profissional com a renda média de R$ 2.965,69 e R$ 10.386,52 (p = 0,006). Não foi encontrada relação significativa entre burnout e as variáveis sociodemográficas e socioeconômicas. Conclusão: Os resultados evidenciam que os médicos residentes estão expostos a situações que contribuem para os altos níveis de estresse e angústia. Ainda são necessários mais estudos sobre o tema.

Mental toughness of resident physicians in a private tertiary hospital in Davao City, Philippines using the mental toughness index

Background@#Mental toughness is believed to be one of the key factors that may help resident physicians endure their training. Objective: Determine the mental toughness of resident physicians in a private tertiary hospital in Davao City, Philippines using the Mental Toughness Index.@*Methods@#The researchers utilized the MTI and added open ended questions to identify positive and negative factors for the Resident’s MTI scores. The questionnaires were distributed to the residents using the online platform. The responses were recorded using the Likert scales and the short answers given were categorized as nominal data.@*Results@#The study had 37 respondents out of 42 total residents with an over-all response rate of 88.09%. The survey showed that female residents have a significantly higher scores. Resident with the age of 31 years and above have greater scores than younger co-residents. The Departments of Surgery and Obstetrics and Gynecology (OB-GYNE) had the highest scores (50.4, SD, +/- 4.04 vs 50.4, SD, +/- 2.79) among all the clinical departments. The Department of Pediatrics had the lowest mean score of 43.67 (SD, +/- 4.39). The study showed that junior residents have the highest MTI mean scores (49, +/- 3.47) and the mid-level of trainees had the lowest mean MTI scores (46.10, SD +/- 3.51). Residents with previous residency training experience have higher mean scores (50.67, SD +/- 4.37). Support Group was the most cited positive factor identified by the trainees. On the other hand, Personal Reasons were the most frequent negative factor that affect their mental toughness.@*Conclusion@#The study showed female residents, residents aged greater than 31 years, Surgical and OB GYNE residents, Junior Residents and Residents with previous residency training have better MTI scores. Social support groups and personal reasons could positively and negatively impact in their mental toughness, respectively.

Síndrome de desgaste profesional en médicos residentes de cuatro hospitales pediátricos de La Habana / Professional burnout syndrome in resident doctors from four pediatric hospitals in Havana

Introducción: La residencia médica constituye una etapa de formación que genera gran estrés, dicha situación puede coadyuvar a la génesis del síndrome de burnout, sin embargo, a pesar de su importancia, ha sido poco investigado en los educandos aspirante a la especialidad de Pediatría. Objetivo: Describir la frecuencia y características del síndrome de desgaste profesional entre residentes de cuatro hospitales pediátricos. Métodos: Estudio descriptivo y transversal realizado en cuatro hospitales pediátricos de la ciudad de La Habana en diciembre del año 2019. Se aplicó el cuestionario validado de Maslach Bournout Inventory. Para el análisis estadístico se definió la presencia del síndrome en tres dimensiones, si el puntaje correspondiente era alto; en situación de presentar en alguna dimensión moderado o bajo fue clasificado como propenso. Los datos cuantitativos de las variables se examinaron a través de medidas de tendencia central y variabilidad. Resultados: La caracterización de la muestra arrojó que el sexo femenino se observó en 91,0 por ciento con edad 33,4 por ciento menor de 30 años y el 66,6 por ciento eran solteros; 36,3 por ciento en los residentes eran del primer y segundo año y 35,5 por ciento de tercero. El síndrome se observó en 6 por ciento de los encuestados y clasificaron como propensos el 84,4 por ciento de la población. Conclusiones: El síndrome de desgaste profesional se observó con poca frecuencia, pero con una gran tendencia a presentarse como propenso entre los residentes de pediatría(AU)

Introduction: Medical residency is a stress-generating training stage. This situation can contribute to the genesis of burnout syndrome; however, despite its importance it has been poorly researched in the students aiming to be Pediatrics specialists. Objective: Describe the frequency and characteristics of professional burnout syndrome among residents of four pediatric hospitals. Methods: Descriptive and cross-sectional study carried out in four pediatric hospitals in Havana city in December, 2019. The validated Maslach Bournout Inventory questionnaire was applied. For statistical analysis, the presence of the syndrome was defined in three dimensions, if the corresponding score was high; or if presenting some moderate or low dimension, it was classified as prone. Quantitative data on variables were examined through central trend measures and variability. Results: The sample characterization showed that the female sex was observed in 91.0 percent with ages 33.4 percent under the age of 30 and 66.6 percent were single; 36.3 percent of the residents were in the first and second year and 35.5 percent in the third year. The syndrome was observed in 6 percent of respondents and 84.4 percent of the population was classified as prone. Conclusions: Professional burnout was observed infrequently, but with a strong tendency to present as prone among pediatric residents(AU)

Burnout, compassion fatigue, and compassion satisfaction among obstetrics and gynecology resident physicians in the Philippines: A cross-sectional study / Philippine Journal of Obstetrics and Gynecology

Introduction@#Physician burnout (BO) is an increasing global concern due to its rising prevalence and effect on patient care@*Objective@#This study determined the prevalence of BO, compassion fatigue (CF), and compassion satisfaction (CS), among residents of obstetrics and gynecology in the Philippines, and identified the factors associated with these@*Methods@#This was a cross‑sectional study, which used stratified random sampling. The strata comprised public and private hospitals that were subdivided into Luzon, Visayas, Mindanao, and National Capital Region. From these, 33 training hospitals were randomly selected, which served as clusters wherein all resident physicians of obstetrics and gynecology were invited to answer either an online or printed version of the Professional Quality of Life Scale Version 5 questionnaire@*Results@#Majority of the 311 participants included had average level of BO (n = 281, 90.4%), CF (n = 237, 76.2%), and CS (n = 213, 68.5%). CS was negatively correlated with burnout (r = −0.31, P < 0.001) and CF (r = −0.34, P < 0.001), whereas BO and CS were positively correlated (r = +0.48, P < 0.001). Type of institution, sleeping hours, and interrupted leaves were the common factors that yield significant differences in BO (P = 0.037, P < 0.001, and P < 0.001) and CF (P = 0.002, P = 0.043, and P = 0.005). Significant differences were observed in CS scores in terms of age (P = 0.016), marital status (P = 0.038), child dependents (P = 0.006), level of training (P = 0.005), and location and type of institution (P ≤ 0.001 and P = 0.003).@*Conclusion@#There is a need to develop active awareness of BO and CF among resident physicians to effect interventions at the individual and institutional level.

Depression among physicians in a government-designated COVID-center hospital during the Coronavirus Disease-19 pandemic

OBJECTIVES@#This study aimed to determine the prevalence, most common symptoms and sociodemographic factors associated with depression among physicians in a government COVID-Center i.e. Southern Philippines Medical Center-Institute of Psychiatry & Behavioral Medicine in Bajada, Davao City@*METHODOLOGY@#This cross-sectional, survey-based study collected socio-demographic data and PHQ-9 scores using Google Forms, from resident physicians from July 1 to August 31 2020. Multinomial logistics regression analysis was used to identify risk factors of depression.@*RESULTS@#Two hundred fifty-one (251) out of 376 physicians responded (68.39% response rate). The average age was 30 years old, majority were female (58.57%, 147), single (78.88%,198), frontliners (77.29%, 194), with average hospital experience of 2.0 years. Ninety six (38.26%) were assigned in surgical departments while 155 (61.75%) worked in nonsurgical departments. There were twelve respondents (4.78%) who had a history of psychiatric illness and 31 (12.35%) had previous psychiatric intervention, while 66 (26.29%) had a history of medical illness. Eighty-five (33.86%) had depression using PHQ-9; 57 (22.71%) as mild, 19 (7.57%) moderate, 7 (2.79%) moderately severe and 2 (0.8%) severe. Out of 85 residents who were depressed, the most common symptoms were: low energy (81, 95.29%); anhedonia (76, 89.41%); and feeling depressed (72, 84.70%). Medical illness was associated with higher levels of depression. Physicians with a history of psychiatric illness, psychiatric intervention and medical illness had significantly higher levels of depression.@*CONCLUSION@#More than a third (33.86%) of physicians screened positive for depression. Current mental health programs must be strengthened and made specific, to prevent and address depression especially among those who have a history of psychiatric and medical illness.

Cross-Sectional Study on the Profiles and the Degree of Burnout among Resident Physicians in Private Tertiary Hospitals in Bacolod City: Proposed Life-Skills Program

@#RESEARCH QUESTION: What are the profiles and the degree of burnout among resident physicians in private tertiary hospitals in Bacolod City? BACKGROUND: Exhaustion from work may result into negative effects not only to the medical staff and patients. Systematic reviews revealed an association in physician burnout and suboptimal quality of care, patient safety and patient satisfaction. However, the prevalence of burnout among resident physicians in Bacolod City has not been established. OBJECTIVES: The study aimed to determine the profiles and the degree of burnout among resident physicians in private tertiary hospitals in Bacolod City. STUDY DESIGN: Cross-sectional survey PARTICIPANTS: We invited all resident physicians in private hospitals in Bacolod City. OUTCOME MEASURE: This study used the 22-item Maslach Burnout Inventory-Human Services Survey. ANALYSIS: IBM SPSS version 22 was used in the data analysis. Mean and frequency distribution were utilized. Analysis of percentage of distribution was used to determine their difference. RESULTS: From December 2019 to January 2020, ninety-three resident physicians consented to participate in the study. The majority of the participants were young adults, females and single. Only a minority of the residents exercised regularly. The majority were practicing their religion. Most of the residents are in their early years of training. Residents in Internal Medicine comprised the majority of the respondents. Among the respondents, in the Emotional Exhaustion (EE) domain: 24.7% were low, 37.6% were moderate, and 37.6% were high. While in the Depersonalization (DP) domain: 43% were low, 34.4% were moderate, and 22.6% were high. Lastly, in the Personal Achievement (PA) domain: 33.3% were low, 35.5% were moderate, and 31.2% were high. High burnout was present in 22.6% among the respondents. CONCLUSIONS: High burn out was seen among young adults, male, single, and more senior resident physicians. Furthermore, residents who exercise regularly and practice their religion have lower burnout. And Internal Medicine residents were seen to have high burnout compared to other training specialization. Organizational- and physician-directed interventions have an essential role in preventing and reducing burnout in training institutions.

The evaluation of application effect of heuristic teaching rounds in cardiovascular disease / 中华医学教育探索杂志

Objective The "heuristic" teaching rounds were applied to cardiovascular diseases and we observed the application effect . Methods From January to March 2017, 56 resident physicians at internal medicine base in the First Affiliated Hospital of Xinjiang Medical University were randomly divided into the experimental group and the control group, with 28 people of each group. The experimental group mainly adopted heuristic teaching rounds, and the control group adopted conventional teaching rounds. Interview method was used to interview the instructors , resident physicians , doctors and nurses in preparation for teaching rounds, the implementation process, the expected goals and effects. 56 resident physicians evaluated the preparation, guidance process, guidance methods and outcomes of ward rounds. SPSS 19.0 was used for statistical analysis, and rank sum test was used for evaluation results. Results As to the familiarity of the instructor on the condition (82.15％vs. 30.86％), guiding the training of humanistic care (92.86％ vs. 39.29％), physical examination (96.43％ vs. 28.57％), analysis of auxiliary examination (85.71％vs. 35.71％), writing medical records (85.72％ vs. 14.29％), summarizing the characteristics of cases (78.57％vs. 35.71％), diagnosis and differential diagnosis (85.71％vs. 21.43％), treatment plan making (85.71％vs. 25.00％), question formulation (89.29％vs. 30.72％), explanation of difficult problems and new progress ( 78 . 57％ vs . 17 . 86％) , content summary ( 92 . 85％ vs . 28 . 58％) the experimental group was significantly higher than the control group. In the experimental group, the teaching rounds of communication (96.43％vs. 46.43％), history acquisition techniques (85.72％vs. 21.43％), examination techniques (92.86％vs. 28.57％), clinical thinking (92.86％ vs. 28.57％), learning interests (96.43％ vs. 25.00％) and efficiency (85.71％ vs. 14.28％), the understanding and memory of knowledge (85.72％ vs. 28.57％), the problem solving ability (89.29％ vs. 21.43％), improvement of team collaboration (67.86％ vs. 28.57％) were significantly higher than those in the control group (P<0.05). Conclusion The "heuristic" teaching rounds attached great importance to preparation before and after class, focusing on resident physicians' active participation and teamwork, integrating humanistic care and communication skills, giving full play to the resident physicians motivation so as to ensure their efficient learning.

Avaliação da Empatia nos Médicos Residentes do Hospital Universitário Alzira Velano em Alfenas, Minas Gerais / Evaluation of Empathy in Medical Residents of Alzira Velano University Hospital in Alfenas, Minas Gerais

RESUMO INTRODUÇÃO Muito se discute a importância da empatia na relação médico-paciente. Poucos estudos avaliaram essa habilidade em médicos residentes (MR). OBJETIVO Avaliar a empatia dos MR do Hospital Universitário Alzira Velano (Huav) por meio da Escala Jefferson de Empatia Médica (Ejem), que fornece quatro tipos de escores: empatia geral (EG); tomada de perspectiva do doente (TP); compaixão (CP) e capacidade de colocar-se no lugar do outro (LO). MÉTODOS A Ejem e um questionário sociodemográfico foram aplicados em 36 MR do Huav no início do segundo semestre de 2016 após assinatura do Termo de Consentimento Livre e Esclarecido. RESULTADOS A análise estatística mostrou que os escores de empatia apresentaram associação em relação às variáveis: sexo, área de atuação (clínica ou cirúrgica) e período da residência em curso. Para a variável sexo, os seguintes achados foram encontrados: MR do sexo feminino do 1° ano apresentaram escores de EG e TP maiores que as MR no ≥ 2°ano (p = 0,01) e (0,03), respectivamente. Em relação à área de atuação, foi encontrado: (a) os escores de EG dos MR do 1° ano eram maiores, comparados aos dos MR no ≥ 2° ano, tanto para a área clínica (p = 0,03) como para a cirúrgica (p = 0,02); (b) MR da área cirúrgica apresentaram escores TP mais elevados no 1° ano em relação aos MR no ≥ 2° ano (p = 0,01). Nenhuma associação aos fatores estudados foi observada para os escores CP e LO. CONCLUSÃO Os dados demonstram que os escores de empatia dos MR dos anos finais são menores em relação aos dos MR do primeiro ano, fato verificado também para MR do sexo feminino. Nossos dados concordam com as observações da literatura e evidenciam a importância do desenvolvimento de estratégias instrucionais para o ensino da empatia entre médicos residentes.

ABSTRACT INTRODUCTION Much is discussed about the importance of empathy in the patient-physician relationship. Few studies have evaluated this ability in resident physicians (RPs). OBJECTIVE To evaluate the empathy of the resident physicians of the University Hospital Alzira Velano (HUAV), through the Jefferson Scale of Empathy (JSE), which provides 4 types of scores: General Empathy (GE); Perspective Taking (PT); Compassionate Care (CC) and Standing in Patient's Shoes (SP). METHODS The JSE and a sociodemographic questionnaire were applied to 36 RPs of the HUAV at the beginning of the second semester of 2016, after they signed the informed consent form. RESULTS Statistical analysis by the Mann-Whitney test showed that empathy scores were associated with variables: gender, area of performance (clinical or surgical) and period of residence in progress. For the variable gender, the following findings were observed: 1) Female RPs of the 1st year had higher GE scores than the RPs in the ≥ 2nd year (p = 0.01) and (0.03), respectively; 2) female RP's of 1st year had higher TP scores than RPs of ≥ 2nd year (p = 0.03). Regarding the area of performance, 1) the GE scores of the 1st year RPs were higher when compared to the RPs in the ≥ 2nd year, both for the clinical (p = 0.03) and for the surgical area (p = 0.02); 2) RPs of the surgical area had higher PT scores in the 1st year compared to RPs in the ≥ 2nd year (p = 0.01). No association was observed between the studied factors and CC and SP scores. CONCLUSION The data show that the empathy scores of the RPs of the final years are lower in relation to the RPs of the 1 st year, a fact also verified for female RPs. Our data are in agreement with the observations of the literature and show the importance of the development of instructional strategies for the teaching of empathy among resident physicians.

Discussion on standardized training of resident physicians of acupuncture and tuina graduate students / 国际中医中药杂志

The standardized training of resident physicians of Chinese medicine specialized graduate students (standardized training) is a great reform of clinical postgraduate education and a major initiative to improve professional degree graduates education. It contributes to higher professional qualities of clinicians in China. At this stage, the standardized training in our school just started and some problems existed such as department arrangement, training and checking system, curriculum and tutors instruction. Here, taking the standardized training in our school as an example, this paper discussed some issues on the training and put forward suggestion. This will help standardize our training, improve the training quality of our graduate students and develope medical professional talents.

Investigating Compliance with Standard Precautions During Residency Physicians in Gynecology and Obstetrics

OBJECTIVES: Physician compliance with standard precautions is important in the specialty of gynecology and obstetrics because of the high frequency of invasive procedures. The current study investigated compliance with standard precautions among resident physicians working in gynecology and obstetrics. METHOD: A cross-sectional study was conducted among resident physicians in gynecology and obstetrics in their first (R1), second (R2) and third (R3) years of residency at a teaching hospital in a city in São Paulo. A structured questionnaire that included demographic and professional aspects and the Standard Precautions Adherence Scale were used to collect data. Statistical analysis was performed using IBM® SPSS version 20. Ethical aspects were considered. RESULTS: Fifty-eight resident physicians participated in the study. Of the enrolled participants, 27 (46.6%) were in R1, 12 (20.7%) were in R2 and 19 (32.8%) were in R3. The standard precautions compliance score was 4.1, which was classified as intermediate. There were no significant differences in the compliance scores of the resident physicians across the three years of residency (H=2.34, p=0.310). CONCLUSION: Compliance with standard precautions among resident physicians was intermediate. Preventive measures in clinical practice are not fully adopted in the specialty of gynecology and obstetrics. More important, many professionals claimed lack of sufficient training in standard precautions in the workplace. Such circumstances should draw the attention of hospital management with regard to occupational health risks.

Application of clinical pathway in the teaching of respiratory medicine for residency standard training program / 中华医学教育探索杂志

Objective To explore the effect and significance of clinical pathway guided teaching in the residency standard training program of respiratory medicine. Methods Total 47 resident physicians were selected and divided into clinical pathway group and control group from March 2014 to November 2014. The pathway group (n=24) was introduced into the teaching guided by clinical pathway management. The control group (n=23) was taught by traditional teaching method. All physicians were tested for the basic theory and the ability of case analysis after 4 weeks training. The ability of chemotherapy strategy ordered by residents independently and correctly was assessed each week during training. A satisfaction questionnaire survey was conducted to evaluate the effectiveness and satisfaction of teaching guided by clinical pathway. GraphPad Prism 5.0 was used and T test was done for comparison of data between groups. Results The medical records about basic theory and case analysis in the pathway group was higher than those in the control group with significant statistical difference (P<0.05). The records of resident physicians who could issue orders for chemotherapy independently and correctly were (70.75±2.79), (81.43±1.91), (85.23±1.3), (90.62±2.34) in the pathway group and (69.65±2.06), (77.11±2.21), (80.3±1.96), (87.78±2.21) in the control group at each week time point. There was statistical increase of the records in the pathway group than in the control group since the second week time point (P<0.05) The overall satisfaction of the pathway group was 95.84%(23/24), and the teaching satisfaction was higher than that of the control group(91.29%, 21/23). Pathway group doctors believe that the relevant teaching effectively improve the level of their knowledge , experience and ability. Conclusions The teaching method guided by clinical pathway is help-ful to standardize the teaching behavior, develop the standardized medical behavior of resident physicians, improve their clinical working ability efficiently, promote the relationship between teaching and studying, which is worth application in the residency standard training program of respiratory medicine.

The TCM apprentice education mode in the application of standardized training of resident physicians / 国际中医中药杂志

Resident standardization training system is established in the framework of modern western medicine. With less consideration to the specificity of TCM on the curriculum, teaching mode and other aspects, it is not suitable for the actual requirement of TCM hospital. TCM apprentice education has a long history, is an important form of the traditional education of Chinese medicine. Leading the TCM apprentice education mode into the standardized training of resident physicians, exploring the construction of the teaching model suited to help the masses of TCM college graduates training will play an increasingly important role in training work.

Effect of Shanghai's standardized training of residents on the history taking mode of physicians / 中华医学教育探索杂志

Objective To evaluate the needs of performing a standardized communication skill training program for residents according to the differences in history taking mode of residents with different degrees and before and after the standardized training in Shanghai Changhai Hospital in 2010.Methods History taking modes of 81 residents in 2010 before and after the standardized training in Shanghai Changhai hospital were categorized.History taking modes were classified into:no effectiveness mode,traditional mode,disease-sickness mode and Calgary-Cambridge Guide mode.Distribution differences of history taking mode of residents with different medical degrees were analyzed by Fisher exact probability method (α =0.05).Distribution differences of history taking mode of residents before and after standardized training were analyzed by Pearson x2 test (α =0.05).Results 19.8％ residents took no effectiveness mode,53.0％ took traditional mode and 27.2％ used disease-sickness mode.There were significant differences in history taking modes among residents with different medical degrees (P =0.008).After training,history taking modes of residents were significantly changed (P=0.001),only 1.2％ residents used no effectiveness mode,59.3％ used traditional mode and 34.6％ used disease-sickness mode.But residents using the Calgary-Cambridge mode were not increased.Conclusions There are significant differences in history taking modes among residents with different medical degrees.History taking mode of residents changed after standardized training.But some of the residents still use non-optimal history taking modes; therefore a standardized communication skill training program might be needed in the future.

Suicídio: um tema pouco conhecido na formação médica / Suicide: a little-known topic in medical trainingt

Esta pesquisa foi realizada em instituição federal pública universitária com o objetivo de melhor conhecer visões, valores e atitudes dos médicos residentes em clínica médica em relação ao suicídio. Trabalhou-se com o conceito de representação social (Moscovici) e a metodologia qualiquantitativa do discurso do sujeito coletivo (DSC) (Lefèvre e Lefèvre). Os discursos revelaram que os médicos residentes se apresentam sensibilizados com a questão do suicídio, entretanto não familiarizados com a bibliografia especializada e nem com os procedimentos de atendimento normatizados pelo Ministério da Saúde e pela OMS. Os pesquisados revelaram dificuldades para identificar e prestar atendimento a pacientes em risco de suicídio. Conclui-se que parece faltar à formação médica (graduação e residência) maior atenção ao tema suicídio.

This research was conducted at a federal university with the aim of understanding better the visions, values and attitudes of resident physicians at medical practices in relation to suicide. The study drew on the concept of social representation (Moscovici) and employed the mixed method of discourse of the collective subject (DCS) (Lefèvre and Lefèvre). The discussions revealed that, although aware of the suicide issue, residents were not familiar with the specialist literature or with the Ministry of Health and WHO standard procedures in such cases. The residents revealed difficulties in identifying and providing care for high suicide risk patients. It is concluded that both university and residency medical training require a greater emphasis on the topic of suicide.

Comparing resident physicians', post-graduate interns' and medical intern's knowledge, perceptions, beliefs & attitudes towards death and dying at the Vicente Sotto Memorial Medical Center, 2001

OBJECTIVE: This study aims to determine the difference in the beliefs, attitudes, knowledge about death and dying, as well as the perception of physicians responsibility towards the dying patient among the medical interns, post-graduate interns (PGI), and resident physicians of Vicente Sotto Memorial Medical Center (VSMMC). METHODOLOGY: A total of 45 respondents were randomly selected, with each group residents, PGIs and interns- having 15 respondents each. This survey used a 4 part self-administered questionnaire, which was given and collected on the same day. Analysis of variance (F value) was used in determining if there was a statistically significant difference among the 3 groups. RESULTS: Majority (91.1%) of the respondents believed in life after death while 8.9 percent did not believe in life after death. Majority (80%) of the respondents had a positive attitude towards death, while 20 percent had a negative attitude toward death. About a third (64.4%) of the respondents were able to give the correct sequence of the stages of death and dying as described by Kubler-Ross. On the 10-item quiz identifying each stage of death and dying the mean scores were as follows: residents = 8.13, PGIs = 8.33, and medical interns = 7.6. Majority of the respondents either strongly agreed or agreed with the statements identifying the responsibilities of the physician to a dying patient, but one statement about the doctors role in giving hope to a dying patient caused some uncertainty among the interns. Analysis of variance showed that the respondents beliefs in life after death, attitudes toward death, and knowledge about the stages of death and dying did not differ significantly.                                                                                                                               CONCLUSION: The VSMMC residents, PGIs, and medical interns believe in life after death, have a positive attitude towards death, have an adequate knowledge on the stages of Death and Dying as well as have a generally good grasp of the physicians responsibilities to the dying patient.