marginal significancep < 0.10
Variables with marginal significance ( p < 0.10) in univariable analyses were included in the multivariable model: Block 1 (individual factors: age, education, years of practice, depersonalization, empathy); Block 2 (institutional factors: availability of psychological services, sufficient variety of psychiatric medications, referral pathways); Block 3 (systemic factors: incentive policies, PMSC training in residency, PMSC training in continuing education).