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首页> 外文期刊>BMC Medical Education >Using focus groups to understand causes for morale decline after introducing change in an IM residency program
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Using focus groups to understand causes for morale decline after introducing change in an IM residency program

机译：在IM居留计划中引入变更后，使用焦点小组来了解导致士气下降的原因

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Background Although program evaluation is a core requirement of Internal Medicine residencies, little is reported in the literature regarding resident satisfaction with training. Most program evaluation consists of numerical rating scales from which it is often difficult to pinpoint exact sources of dissatisfaction. Methods Our goal in this work is to evaluate the utility of focus group methodology to uncover in detail the reasons for residents’ deteriorating morale in an IM residency program, as well as to solicit suggestions for correction. This study employed focus groups (FG) in a qualitative research design, in which descriptive statistics from a resident program evaluation survey served to guide an intensive focus group process. Participants were 40 of 45 2nd and 3rd year internal medicine residents enrolled in the IM residency training program. Five chief residents were trained to conduct 5 focus groups with 8 residents in each group. The focus groups examined possible issues contributing to the deterioration of morale noted in the quantitative survey. Results Many unexpected themes were uncovered by the FGs. Residents identified the following factors as the major contributors to deteriorating morale: 1) Pace of change 2) Process of change 3) The role of chief residents in change 4) Fear of intimidation and retaliation. Groups also suggested practical recommendations for improving the culture of the residency. Conclusion Introducing change in residency training is a challenging process. Respectful attention to resident frustrations and solution-focused discussions are necessary to understand and improve morale. Focus groups proved to be a useful tool in revealing the precise source of pervasive resident concerns as well as providing potential solutions. In addition, FGs methodology can be adapted in a practical manner to residency evaluation.
机译：背景技术尽管计划评估是内科住院医师的核心要求，但有关居民对培训的满意度的文献报道很少。大多数计划评估由数字等级量表组成，通常很难从中找到确切的不满意根源。方法我们在这项工作中的目标是评估焦点小组方法的实用性，以详细发现IM居留计划中居民士气恶化的原因，并征求纠正建议。这项研究在定性研究设计中采用了焦点小组（FG），其中来自居民项目评估调查的描述性统计数据可指导密集的焦点小组过程。参加IM住院医师培训计划的45名2 nd 和3 年内科住院医师中的40名参加者。对五名主要居民进行了培训，以进行5个焦点小组的调查，每组8个居民。专题小组审查了可能导致定量调查中提到的士气下降的问题。结果FG发现了许多意外的主题。居民认为，以下因素是导致士气下降的主要因素：1）变化的步伐2）变化的过程3）主要居民在变化中的作用4）害怕受到恐吓和报复。小组还提出了改善居住文化的实用建议。结论在住院医师培训中引入变革是一个具有挑战性的过程。要理解和提高士气，必须对居民的挫败感和对解决方案的讨论给予足够的重视。事实证明，焦点小组是一个有用的工具，可用于揭示居民普遍关注的确切原因并提供潜在的解决方案。此外，FG的方法可以以实用的方式适应居住评估。

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