The natural history of cynicism in physicians

Testerman, John K.; Morton, Kelly R.; Loo, Lawrence K.; Worthley, Joanna S.; Lamberton, Henry H.

doi:10.1097/00001888-199610000-00040

Cited by 85 publications

(66 citation statements)

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“…Algumas situações são mais frequentes e repetitivas: estresse ligado às provas e às vivências ao cuidar dos pacientes com doenças graves ou em fase terminal, no relacionamento interpessoal com superiores que se caracterizam por autoritarismo, rigidez e desumanidade e ao presenciar comportamentos não profissionais por parte de alguns médicos frente aos pacientes. [7][8][9][10][11][12][13] Nos currículos médicos tradicionais esses eventos são observados a partir do quarto ano e têm sua frequência aumentada no internato. Já nas novas grades curriculares, como a de nossa faculdade, o contato com a assistência médica e os pacientes é antecipado já para o início do curso e, portanto, pode ampliar o tempo de exposição a esses estressores.…”

Section: Discussionunclassified

Resiliência em estudantes de medicina ao longo do curso de graduação

Pedroso

Ricci

Evangelista

et al. 2016

Rev. Fac. Ciênc. Méd. Sorocaba

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RESUMOObjetivos e Método: Estudo transversal, descritivo, para identificar o grau de resiliência nos estudantes do Curso de Medicina da Faculdade de Ciências Médicas e da Saúde da Pontifícia Universidade Católica de São Paulo (FCMS/ PUC-SP). Comparar a resiliência entre os diferentes anos e relacionar e comparar o grau de resiliência com variáveis demográficas e socioeconômicas. Resultados: A amostra teve idade média de 21,68, 270 solteiros (98,18%), de cor branca 240 (87,27%) e com renda familiar de mais de 20 salários (34,54%). Na escala de resiliência obtiveram uma média de 114 (DP=14,05). Não se observou diferença significante entre os pontos obtidos no decorrer da graduação. Observase um predomínio de resiliência moderada em todos os anos do curso e, consequentemente, no total. A resiliência nos estudantes de Medicina, segundos os resultados dos estudos, demonstra-se como uma característica individual e que não guarda relações com gênero, idade, orientação sexual, cor e condições de habitação entre os vários anos do curso. Conclusão: Conclui-se que o grau de resiliência de estudantes de Medicina pode ser considerado predominantemente moderado, porém com alta variância. Não se observa correlação com renda familiar. Palavras-chave: resiliência psicológica; estudantes de medicina; qualidade de vida. ABSTRACT Objective and Method:This is a descriptive study to identify the degree of resilience in medical students at Pontifical Catholic University of São Paulo, compare the resilience of different years of undergraduation and relate and compare the degree of resilience to demographic and socioeconomic status. Results: The study population has an average age of 21.68, single 270 (98.18%), caucasians 240 (87.27%), household income of more than 20 minimum wages (34.54%). In resilience general index it was obtained an average of 114 (SD=14.05). There was no significant difference between the scores obtained on the scale during graduation years. It was observed a predominance of moderate resilience in all years of the course and in the total sample. Resilience in medical students, it is shown as an individual characteristic and does not keep relations with gender, age, sexual orientation, race or housing conditions in the various years of the course. Conclusion: It was concluded that there is a predominance of moderate resilience among the medical students. There was no correlation between resilience and familiar income Keywords: psychological resilience; medical students; quality of life. INTRODUÇÃOA origem do termo resiliência provém da Física e indica a propriedade pela qual a energia armazenada em um corpo deformado é devolvida quando cessa a tensão causadora de uma deformação elástica. Em virtude da transposição desse conceito para as Ciências Sociais, a definição do termo resiliência esteve muito relacionada à ideia de "invulnerabilidade" e de "adaptação". 1 Atualmente, os sentidos da resiliência têm a ver também com o processo dinâmico de reconstrução do si mesmo, sob o aspecto potencial.1 Na experiência resili...

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Section: Discussionunclassified

Resiliência em estudantes de medicina ao longo do curso de graduação

Pedroso

Ricci

Evangelista

et al. 2016

Rev. Fac. Ciênc. Méd. Sorocaba

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“…Previous studies suggest that cynicism is a prevalent feature of medical culture 11,13,29,30 and may have significant consequences for physicians' behaviors and attitudes. 31 Furthermore, cynicism may result in loss of empathy and decreased humanism, 10 traits needed to form strong patient-physician relationships.…”

Section: Discussionmentioning

confidence: 99%

The Effect of the Hidden Curriculum on Resident Burnout and Cynicism

Billings¹,

Lazarus²,

Wenrich³

et al. 2011

Journal of Graduate Medical Education

102

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Introduction Residents learn and participate in care within hospital cultures that may tolerate unprofessional conduct and cynical attitudes, labeled the “hidden curriculum.” We hypothesized that this hidden curriculum may have deleterious effects on residents' professional development and investigated whether witnessing unprofessional behavior during residency was associated with burnout and cynicism. Methods We surveyed internal medicine residents at 2 academic centers for 3 years (2008–2010). Hidden curriculum items assessed exposure to unprofessional conduct. We used regression analyses to examine if hidden curriculum scores were associated with cynicism and the Maslach Burnout Inventory depersonalization and emotional exhaustion domain scores. Results The response rate was 48% (337 of 708). In the 284 surveys analyzed, 45% of respondents met burnout criteria and had significantly higher hidden curriculum scores (26 versus 19, P < .001) than those not meeting criteria. In cross-sectional analyses, the hidden curriculum score was significantly associated with residents' depersonalization, emotional exhaustion, and cynicism scores. Cynicism scores were also associated with burnout. Conclusions Exposure to unprofessional conduct was associated with higher burnout and cynicism scores among internal medicine residents. We also found that cynicism and burnout were significantly associated and may be measures of similar but not necessarily identical responses to the challenges posed by residency. Measuring the hidden curriculum and cynicism may provide direction for educators attempting to reform hospital culture and improve resident well-being.

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“…Springer further cynicism and distancing strategies as training progresses. 43,44 In this area, we have preliminary qualitative evidence that writing appears to provide learners with a mechanism for cultivating empathy toward patients, at least by their own self-report. 45 Point-of-view writing assignments, for example, demand that learners adopt the voice and viewpoint of the patient, which both moves them emotionally closer to and promotes understanding of initially unsympathetic characters.…”

Section: Empathymentioning

confidence: 85%