Draper B, Luscombe G, Winfield S
Academic Department of Old Age Psychiatry, Prince of Wales Hospital, Randwick, New South Wales, Australia.
Aust N Z J Psychiatry. 1999 Oct;33(5):709-16. doi: 10.1080/j.1440-1614.1999.00623.x.
The aim of this study is to determine the effects of experience on the practice, roles, status and attitudes of psychiatrists within the Royal Australian and New Zealand College of Psychiatrists (RANZCP).
A postal survey of Fellows of the RANZCP resident in Australia or New Zealand was conducted. The main outcome measures were: years of psychiatric experience; higher medical qualifications; location and type of psychiatric practice; attitudes about senior psychiatrists and mentorship; changes in work practices over the career; and the perceived benefits and drawbacks of experience on psychiatric practice and case selection.
Of 1086 eligible subjects, 629 participated. Over 96% of respondents, particularly the younger and less experienced, believed that senior psychiatrists have wisdom to offer to junior colleagues. This wisdom principally related to mentorship/supervision. Increased 'respect and tolerance' of patients as a benefit of experience was more likely to be reported by respondents who were more experienced. Respondents more confident about treating younger patients and treating functional psychoses were more likely to be less experienced, as were those reluctant to take on psychotherapy cases. Those respondents reluctant to take on 'dangerous or acting-out patients' were more experienced. The field of psychiatric practice significantly influenced case selection.
Senior psychiatrists have accumulated wisdom through experience that is sought by junior colleagues via mentorship. It is recommended that the RANZCP should specifically address the needs of early career and senior psychiatrists.
本研究旨在确定经验对澳大利亚和新西兰皇家精神科医学院（RANZCP）内精神科医生的实践、角色、地位和态度的影响。
对居住在澳大利亚或新西兰的RANZCP会员进行了邮寄调查。主要结果指标包括：精神科经验年限；更高的医学资格；精神科实践的地点和类型；对资深精神科医生和指导的态度；职业生涯中工作实践的变化；以及经验对精神科实践和病例选择的感知益处和弊端。
在1086名符合条件的受试者中，629人参与了调查。超过96%的受访者，尤其是年轻和经验较少的受访者，认为资深精神科医生有智慧可以传授给初级同事。这种智慧主要与指导/监督有关。经验更丰富的受访者更有可能报告说，作为经验的益处，对患者的“尊重和宽容”有所增加。对治疗年轻患者和功能性精神病更有信心的受访者经验更有可能较少，那些不愿意接手心理治疗病例的受访者也是如此。那些不愿意接手“危险或有冲动行为的患者”的受访者经验更丰富。精神科实践领域对病例选择有显著影响。
资深精神科医生通过经验积累了智慧，初级同事通过指导寻求这些智慧。建议RANZCP应特别关注早期职业生涯精神科医生和资深精神科医生的需求。
