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J Gen Intern Med. 2019 May;34(5):773-777. doi: 10.1007/s11606-019-04886-y.

"I Cannot Take This Any More!": Preparing Interns to Identify and Help a Struggling Colleague.

Author information

1
Department of Medicine, Division of General Internal Medicine and Clinical Innovation, NYU School of Medicine, 550 First Avenue, New York, NY, 10016, USA. Sondra.Zabar@nyulangone.org.
2
Department of Medicine, Division of General Internal Medicine and Clinical Innovation, NYU School of Medicine, 550 First Avenue, New York, NY, 10016, USA.
3
Department of Surgery, NYU School of Medicine, New York, NY, USA.
4
Department of Orthopedic Surgery, NYU School of Medicine, New York, NY, USA.
5
Institute for Innovation in Medical Education, Division of Quality and Evaluation and Department of Medicine, Division of General Internal Medicine and Clinical Innovation, NYU School of Medicine, New York, NY, USA.

Abstract

BACKGROUND:

Few programs train residents in recognizing and responding to distressed colleagues at risk for suicide.

AIM:

To assess interns' ability to identify a struggling colleague, describe resources, and recognize that physicians can and should help colleagues in trouble.

SETTING:

Residency programs at an academic medical center.

PARTICIPANTS:

One hundred forty-five interns.

PROGRAM DESIGN:

An OSCE case was designed to give interns practice and feedback on their skills in recognizing a colleague in distress and recommending the appropriate course of action. Embedded in a patient "sign-out" case, standardized health professionals (SHP) portrayed a resident with depressed mood and an underlying drinking problem. The SHP assessed intern skills in assessing symptoms and directing the resident to seek help.

PROGRAM EVALUATION:

Interns appreciated the opportunity to practice addressing this situation. Debriefing the case led to productive conversations between faculty and residents on available resources. Interns' skills require further development: while 60% of interns asked about their colleague's emotional state, only one-third screened for depression and just under half explored suicidal ideation. Only 32% directed the colleague to specific resources for his depression (higher among those that checked his emotional state, 54%, or screened for depression, 80%).

DISCUSSION:

This OSCE case identified varying intern skill levels for identifying and assessing a struggling colleague while also providing experiential learning and supporting a culture of addressing peer wellness.

KEYWORDS:

OSCE; burnout; depression; struggling colleague; substance use

PMID:
30993628
PMCID:
PMC6502915
[Available on 2020-05-01]
DOI:
10.1007/s11606-019-04886-y

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