UNASSIGNED: We sought to understand well-being from the perspectives of residents in a family medicine residency program and to assess the residents\' opinions on implementing \"Reflection Rounds\" (RR) to promote wellness and combat burnout through self-reflection. These aims were achieved through descriptive qualitative analysis of a focus group of family medicine residents.
UNASSIGNED: Participation was voluntary and open to all 45 residents in the program. The final participant sample consisted of 14 residents who shared similar characteristics, including level of training and being exposed to similar training stressors. Both a priori and open coding were used for this analysis.
UNASSIGNED: An iterative process identified themes based on focus group responses. The residents were in favor of initiating RR and recommended discussion topics unique to family medicine residency. They also identified logistical preferences for this intervention, such as conducting confidential and unrecorded groups, splitting rounds by training year, offering RRs led by a trained facilitator, providing snacks if feasible, and making the RRs available on a regular basis during protected didactic time.
UNASSIGNED: This project elucidates how residents are identifying and managing wellness and burnout as well as informs effective ways that family medicine residency programs can incorporate RR into their wellness curriculum.

Description In this review, we argue that exercise (physical activity) be monitored as a vital sign since no other basic sign or symptom provides as much information about a patient\'s health status. The influence of regular exercise on patient health is indisputable, with strong evidence to show the power of exercise to mitigate chronic disease and improve overall health. Several simple tools, such as Physical Activity as a Vital Sign and Exercise as a Vital Sign are available to assess patient physical activity. When properly applied, there is evidence to support the efficacy of these tools, but there are barriers that prevent broad inclusion in primary care, among which are time and provider knowledge. In our review, we also discussed the value of physician-led lifestyle discussions with patients and found they view these discussions favorably. There is also evidence that physicians who exercise are more likely to have these lifestyle discussions with their patients, but the proportion of physicians who exercise regularly is fairly low. We believe physicians\' awareness of their patients\' sedentary lifestyles should prompt a prescription to increase physical activity, but additional in-clinic support and community resources need to be in place for patients to get a regular dose.

UNASSIGNED: This study evaluated wellness programs in a large hospital network to determine residency program directors\' (PDs) perspectives on their wellness programs\' state, including wellness prioritization, frequency of wellness activities, and wellness\' influence on decision-making across organizational levels.
UNASSIGNED: In 2021, 211 PDs were sent surveys on program policies, program implementation frequency, perceptions of the administration\'s ability to prioritize wellness, funding sources, and perceptions of resident wellness\' impact on decision-making.
UNASSIGNED: Among 211 contacted programs, 148 surveys were completed (70.1%). The majority reported having wellness programs, committees, and funding. Fewer than 25% reported having a chief wellness officer. PDs perceived that fellow colleagues in their institution linked wellness to markers of institutional success to a greater extent than other available options (ie, Accreditation Council for Graduate Medical Education [ACGME] requirements, budgetary concerns, resident input, core faculty priorities, and education quality). Financial well-being was perceived as least connected to wellness. Perceptions of wellness were rated across 3 organizational levels: program, institution, and organization. Across all levels, ACGME requirements (31.0%-32.8%) and budgetary/financial concerns (21.9%-37.0%) were perceived as having the most significant influence on overall decision-making, whereas resident wellness was rated lower in influence (8.0%-12.2%). Most programs allowed residents to attend mental health appointments without using paid time off (87.9%) and while on duty (83.1%).
UNASSIGNED: The frequency of wellness activities varied greatly across programs. PDs reported challenges making resident self-care and personal development a priority and perceived resident wellness as having limited importance to decision-making at higher levels.

暂无摘要。

OBJECTIVE: This study aims to examine whether perceived levels of job stress, burnout, and mental health are different according to demographic characteristics and working conditions and to investigate the direct and indirect effects of job stress and burnout on the mental health of medical faculty members.
METHODS: The study sample consists of 855 faculty members in 40 medical schools nationwide in the 2020 Burnout of Faculty Members of Medical Schools in Korea data with a grant from the Korean Association of Medical Colleges. This study employed structural equation modeling to construct causality among latent variables in addition to t-test, analysis of variance, and correlation coefficients for bivariate analyses.
RESULTS: Perceived job stress, burnout, and mental health levels of medical faculty members showed significant group differences by demographic characteristics and working conditions. Job stress directly affected mental health (β=0.215, p<0.01) and indirectly affected mental health via burnout (β=0.493, p<0.001). Thus burnout significantly mediated the relationship between job stress and the mental health of medical faculty members.
CONCLUSIONS: This study found that job stress has direct and indirect effects on the mental health of medical faculty members, and burnout partially mediated this relationship. Further studies need to intervene in job stress and burnout to prevent the adverse mental health of medical faculty members and to introduce proper measures to improve working conditions affecting job stress and burnout.

This study examined the influence of counselors\' sense of calling on psychological burnout, mediated by meaning of work and living a calling, based on the work as a calling theory (WCT) and preceding studies. Furthermore, the sequential mediating effects of meaning of work and living a calling were investigated. Data were collected from 420 Korean counselors working in counseling centers located nationwide and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). The results revealed that a sense of calling negatively impacted psychological burnout. Second, the sense of calling did not affect psychological burnout through the mediation of meaning of work. Third, the sense of calling negatively impacted psychological burnout through the mediation of living a calling. Fourth, the sense of calling negatively affected psychological burnout through the sequential mediation of meaning of work and living a calling. Based on this study\'s findings, implications can be provided to enhance counselors\' professional calling and reduce psychological burnout, thereby aiding them in resolving their psychological issues during counseling practice and providing higher-quality psychological services to clients. Suggestions for improvements and future research are also discussed.

This survey evaluated whether the COVID-19 pandemic was a traumatic stress event for family physicians associated with burnout, changes in life priorities, and intentions to retreat from clinical practice.
We report on 683 clinically active family physicians surveyed through the Council of Academic Family Medicine\'s Educational Research Alliance (CERA) in the fall of 2021.
Overall, 35.2% of family physicians experienced the pandemic as a traumatic stress like event. This was associated with changing life priorities (OR 2.6, CI 1.8-3.9), burnout (OR 1.6, CI 1.1 to 2.4), and withdrawal from clinical practice in various ways. Those who changed their priorities in life were more likely to restrict scope of practice (OR 3.9, CI 2.6-5.9), reduce clinical work effort (OR 3.4, 2.3 to 5.1), relocate (OR 3.1, CI 2.0 to 4.8), retire (OR 2.7, CI 1.4-4.9), reroute their career away from patient care (OR 2.1, CI 1.4-3.1) and less likely to avoid redesigning the practice to improve well-being (OR 0.3, CI 0.2-0.7). Those who experienced burnout were more likely to retire (OR 5.5, CI 2.8 to 10.5), reduce clinical work effort (OR 4.2, CI 2.9-6.1), reroute their career away from patient care (OR 3.9, CI 2.6-5.8), relocate (OR 3.8, CI 2.4 to 5.9), and restrict scope of practice (OR 3.3, CI 2.3 to 4.9). Overall, 48.5% of family physicians expressed some intention to retreat from clinical practice.
The COVID-19 pandemic impacted family physician\'s career plans. Remedying burnout is a high-yield opportunity for retaining clinically active family physicians. Physicians retreating from clinical medicine related to changing life\'s priorities needs further exploration.

OBJECTIVE: Burnout syndrome (BS) has been evaluated in few populations of medical students, and its relationship with depression is even less studied. The objective was to determine the frequency of BS in medical students of the Universidad Pedagógica y Tecnológica de Colombia (UPTC), in Tunja, Colombia, as well as its association with depression and other social, economic, demographic, and academic factors.
METHODS: An observational, analytical, cross-sectional study was carried out on 182 UPTC medical students during 2018. The Maslach Burnout Inventory-Student Survey (MBI-SS) was applied, with which 3 components were obtained to determine positive SB. This was crossed in the Stata 15 program for depression and other social, economic, demographic, and academic covariates with the Generalised Linear Model (GLM).
RESULTS: Of 182 respondents, 51.4% were women. The median age was 21 years (20-23 years). 14% had BS, of which 48% had depression. In the multiple regression, BS was significantly associated with a higher frequency of depression (RPa = 5.54; IC95%, 2.36-13.02; P < 0.001) and the feeling of insufficient money (RPa = 4.37; IC95%, 1.95-9.83; P < 0.001), in contrast to a negative association with smoking (RPa = 0.13; IC95%, 0.06-0.30; P < 0.001) and being a woman (RPa = 0.32; IC95%, 0.12-0.82; P = 0.018). The age of onset of marijuana use was not significant.
CONCLUSIONS: BS shows a high association with increased depression and a feeling that the money is not enough at the end of the month, but it showed a negative association with tobacco consumption and being a woman. Such students should be detected to provide them with adequate academic support.

This study investigated the prevalence of burnout in physical therapists in the United States and the relationships between burnout and education, mentorship, and self-efficacy.
This was a cross-sectional survey study. An electronic survey was distributed to practicing physical therapists across the United States over a 6-week period from December 2020 to January 2021. The survey was completed by 2,813 physical therapists from all states. The majority were female (68.72%), White or Caucasian (80.13%), and employed full-time (77.14%). Respondents completed questions on demographics, education, mentorship, self-efficacy, and burnout. The Burnout Clinical Subtypes Questionnaire 12 (BCSQ-12) and self-reports were used to quantify burnout, and the General Self-Efficacy Scale (GSES) was used to measure self-efficacy. Descriptive and inferential analyses were performed.
Respondents from home health (median BCSQ-12=42.00) and skilled nursing facility settings (median BCSQ-12=42.00) displayed the highest burnout scores. Burnout was significantly lower among those who provided formal mentorship (median BCSQ-12=39.00, P=0.0001) compared to no mentorship (median BCSQ-12=41.00). Respondents who received formal mentorship (median BCSQ-12=38.00, P=0.0028) displayed significantly lower burnout than those who received no mentorship (median BCSQ-12=41.00). A moderate negative correlation (rho=-0.49) was observed between the GSES and burnout scores. A strong positive correlation was found between self-reported burnout status and burnout scores (rrb=0.61).
Burnout is prevalent in the physical therapy profession, as almost half of respondents (49.34%) reported burnout. Providing or receiving mentorship and higher self-efficacy were associated with lower burnout. Organizations should consider measuring burnout levels, investing in mentorship programs, and implementing strategies to improve self-efficacy.

Physician departure causes considerable disruption for patients, colleagues, and staff. The cost of finding a new physician to replace the loss coupled with lost productivity as they build their practice can cost as much as $1 million per departure. Therefore, we sought to characterize drivers of departure from practice with the goal of informing retention efforts (with a special emphasis on the connection between electronic health record (EHR)-related stress and physician departure).
This qualitative study of semistructured interviews was conducted between October 2021 and April 2022 among 13 attending physicians who had voluntarily departed their position from 2018 to 2021 in a large multispecialty, productivity-based, ambulatory practice network in the Northeast with a 5% annual turnover rate to understand their reasons for departing practice.
Among the 13 participants, 8 were women (61.5%), 3 retired (23.1%), and 6 (46.2%) left for new positions. Major domains surrounding the decision to depart included current features of the health care delivery landscape, leadership/local practice culture, and personal considerations. Major factors within these domains included the EHR, compensation model, emphasis on metrics, leadership support, teamwork/staffing, burnout, and work-life integration.
Opportunities for medical practices to prevent ambulatory physicians\' turnover include: (1) addressing workflow by distributing responsibility across team members to better address patient expectations and documentation requirements, (2) ensuring adequate staffing across disciplines and roles, and (3) considering alternative care or payment models.